Aims to evaluate the incidence of cardiac arrhythmias during a lockdown period due to COVID-19 pandemics in a population followed by remote monitoring through implanted cardiac defibrillators. Methods and results In this retrospective, multicentre cohort study, we included 574 remotely monitored automatic (AICD) and cardiac resynchronization devices (CRT-D) recipients implanted before January 1st 2019 at seven Hospitals of Campania Region, comparing the incidence of arrhythmias occurred during the lockdown period due to COVID-19 epidemics (from March 9th to May 1st 2020) with the arrhythmias rate of the corresponding period in 2019. An effective retrospective data collection was performed through remote monitoring, as this tool allows the direct transfer of the the information stored by the implantable devices to medical personnel. During the lockdown period, we observed ventricular tachyarrhythmias (ventricular tachycardia or fibrillation) in 25 (4.8%) patients as compared to 12 (2.3%) during the corresponding 2019 period (p < 0.04); new-onset atrial fibrillation was detected in 38 (8.2%) subjects during lockdown period and in 24 (5.2%) during the reference period (p < 0.004). Conclusion During pandemics lockdown period we observed an higher incidence of arrhythmic events in ICD/CRT-D patients followed up through device remote monitoring by seven hospitals of Campania region.

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