Abstract
Aims
Mood disorders are common in patients with cardiac implantable electronic devices (CIEDs). The COVID-19 pandemic may have further undermined their emotional well being exacerbating physical symptoms such as palpitations. We investigated the occurrence of anxiety and palpitations in CIEDs patients during the pandemic. In those with remote monitoring (RM) available, we evaluated whether these symptoms were associated with arrhythmic events.
Methods and results
The generalized anxiety disorder (GAD) 7-items questionnaire and the frequency of palpitations were assessed by telephonic interview. Overall 152 CIEDs patients agreed to be interviewed (119 males, age 69 ± 14 years). The RM was available in 54/152 (36%). Thirty-seven (24%) and 43 (28%) patients had anxiety and palpitations, respectively, and 23 (15%) patients had both. Women were more likely to have symptoms than men (50% vs. 20%; P < 0.01 for anxiety and 53% vs. 24%; P < 0.01 for palpitations). Among patients with palpitations the RM was available in 17/43 (40%) and revealed true arrhythmic events in 7/17 (41%) patients: eight non-sustained ventricular tachycardias (NSVT), two supra-ventricular tachycardias (SVT), four sustained ventricular tachycardias (VT). The RM enabled to detect in six patients a device malfunctioning: in two increased impedance in the shock lead, in three increased capture threshold for the LV lead and in one the battery reached the end of life.
Conclusions
Patients with CIEDs were likely to experience anxiety and palpitations during the COVID-19 outbreak and the RM has been pivotal to ascertain the occurrence of arrhythmic events and device malfunctioning in symptomatic and asymptomatic patients as well.
Anxiety and palpitations in patients with cardiac implantable electronic devices (CIEDs) and the added value of remote monitoring (RM) in the COVID-19 pandemic: an Italian single-centre experience
