Clinical Characteristics of Shocks in Patients with implanted
cardioverter defibrillator Following COVID-19 Infection
Abstract
Background and Aims: The relationship between SARS-CoV-2
infection and ICD shock remains unclear. We analyzed the characteristics
of patients received shocks after SARS-CoV-2 infection to explore causes
of these shocks to provide information for subsequent treatment.
Methods: We retrospectively analyzed data from seven patients
who hospitalized the First People’s Hospital of Yunnan Province between
December 2022 and January 2023 after experiencing ICD shock or
ventricular arrhythmias following SARS-CoV-2 infection. We collected
baseline information i.e., age and sex, device type, arrhythmia type,
comorbidities, etc to analyze the causes of electrical shocks.
Results: All patients’ devices were implanted in our hospital.
The patients’ mean age was 67±10 years. Four underwent implantation for
primary prevention, and three for secondary prevention. These patients
received 80 ICD shocks after SARS-CoV-2 infection, 71 (88.75%) nine
(11.25%) of which were treatment for ventricular tachycardia and atrial
fibrillation, respectively. There were 54 antitachycardia pacing(ATP)
treatments, which forty-eight arrhythmic events were terminated through
antitachycardia pacing and six not. Laboratory tests conducted upon
admission revealed that six patients had blood potassium levels below
4.0 mmol/L. Five patients had blood calcium levels below 2.11 mmol/L.
Four of seven patients had elevated troponin concentrations
(0.030–0.297 ng/mL). All patients had significantly elevated N-terminal
pro-B-type natriuretic peptide levels (608.8–25,758 pg/mL). Six
patients had a QT interval of > 440 ms and a mean QT
interval of 460±46 ms. Conclusion: SARS-CoV-2 infection may be
associated with ICD shock. Clinicians should pay close attention to
patients with implanted devices after SARS-CoV-2 infection and actively
eliminate arrhythmogenic triggers to minimize the likelihood of ICD
shock.