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
Abstract
Background. Mood disorders are common in patients with cardiac
implantable electronic devices (CIEDs). The lockdown related to 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 in CIEDs patients Overall 152 CIEDs patients agreed
to be interviewed (119 males, age 69±14 years). The RM was available in
54/152 (36%). Thirtyseven (24%) and 43 (28%) patients experienced
anxiety and palpitations respectively, and 23 (15%) patients
experienced 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 the following arrhythmias
in 7/17 (41%) patients: 8 non-sustained ventricular tachycardias
(NSVT), 2 supra-ventricular tachycardias (SVT), 4 sustained ventricular
tachycardias (VT). The RM enabled to detect in 6 patients a device
malfunctioning: in 2 increased impedance in the shock lead, in 3
increased capture threshold for the LV lead and in 1 the battery reached
the end of life Conclusion. Patients with CIEDs during the COVID19
outbreak were likely to experience anxiety and palpitations and the RM
has been pivotal to ascertain the occurrence of arrhythmic events and
device malfunctioning