Implantable Cardioverter Defibrillator Multisensor Monitoring during Home Confinement Caused by the COVID-19 Pandemic
by
, , , , , , , and
Matteo Ziacchi
1,*
,
Leonardo Calò
2,
Antonio D’Onofrio
3,
Michele Manzo
4,
Antonio Dello Russo
5,
Luca Santini
6
,
Giovanna Giubilato
7,
Cosimo Carriere
8,
Vincenzo Ezio Santobuono
9
,
Gianluca Savarese
10,
Carmelo La Greca
11,
Giuseppe Arena
12
,
Antonello Talarico
13,
Ennio Pisanò
14,
Massimo Giammaria
15,
Antonio Pangallo
16,
Monica Campari
17,
Sergio Valsecchi
17 and
Igor Diemberger
1 1
Institute of Cardiology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Policlinico S.Orsola-Malpighi, 40138 Bologna, Italy
2
Policlinico Casilino, 00118 Rome, Italy
3
“Unità Operativa di Elettrofisiologia, Studio e Terapia delle Aritmie”, Monaldi Hospital, 80131 Naples, Italy
4
OO.RR. San Giovanni di Dio Ruggi d’Aragona, 84125 Salerno, Italy
5
Clinica di Cardiologia e Aritmologia, Università Politecnica delle Marche, “Ospedali Riuniti”, 60126 Ancona, Italy
6
“Giovan Battista Grassi” Hospital, 00122 Rome, Italy
7
“F. Spaziani” Hospital, 03100 Frosinone, Italy
8
Azienda Ospedaliera Universitaria Ospedali Riuniti di Trieste—Cattinara, 34149 Trieste, Italy
9
Policlinico di Bari, University of Bari, 70126 Bari, Italy
10
S. Giovanni Battista Hospital, 06034 Foligno, Italy
11
Fondazione Poliambulanza, 25124 Brescia, Italy
12
Ospedale Civile Apuane, 54100 Massa, Italy
13
SS. Annunziata Hospital, 87100 Cosenza, Italy
14
Vito Fazzi Hospital, 73100 Lecce, Italy
15
Division of Cardiology, Maria Vittoria Hospital, 10144 Turin, Italy
16
Grande Ospedale Metropolitano “Bianchi-Melacrino”, 89124 Reggio Calabria, Italy
17
Boston Scientific Italia, 20134 Milan, Italy
*
Author to whom correspondence should be addressed.
Biology 2022, 11(1), 120; https://doi.org/10.3390/biology11010120
Submission received: 13 December 2021
/
Revised: 10 January 2022
/
Accepted: 11 January 2022
/
Published: 12 January 2022
(This article belongs to the Special Issue Biophysics Arrhythmias and Pacing)
Simple Summary
During the COVID-19 pandemic, utilization of remote monitoring platforms was recommended. The HeartLogic algorithm identifies patients at risk of heart failure events, combining multiple sensors available on implantable cardioverter defibrillators. This analysis examined how multiple CIED sensors behave in periods of anticipated restrictions pertaining to physical activity. We demonstrated a significant drop in median activity level immediately after the implementation of stay-at-home orders, whereas there was no difference in the other contributing sensors. The weekly rate of heart failure alerts was significantly higher during the lockdown and post-lockdown than that reported in the pre-lockdown.
Abstract
Aims: The utilization of remote monitoring platforms was recommended amidst the COVID-19 pandemic. The HeartLogic index combines multiple implantable cardioverter defibrillator (ICD) sensors and has proved to be a predictor of impending heart failure (HF) decompensation. We examined how multiple ICD sensors behave in the periods of anticipated restrictions pertaining to physical activity. Methods: The HeartLogic feature was active in 349 ICD and cardiac resynchronization therapy ICD patients at 20 Italian centers. The period from 1 January to 19 July 2020, was divided into three phases: pre-lockdown (weeks 1–11), lockdown (weeks 12–20), post-lockdown (weeks 21–29). Results: Immediately after the implementation of stay-at-home orders (week 12), we observed a significant drop in median activity level whereas there was no difference in the other contributing parameters. The median composite HeartLogic index increased at the end of the Lockdown. The weekly rate of alerts was significantly higher during the lockdown (1.56 alerts/week/100 pts, 95%CI: 1.15–2.06; IRR = 1.71, p = 0.014) and post-lockdown (1.37 alerts/week/100 pts, 95%CI: 0.99–1.84; IRR = 1.50, p = 0.072) than that reported in pre-lockdown (0.91 alerts/week/100 pts, 95%CI: 0.64–1.27). However, the median duration of alert state and the maximum index value did not change among phases, as well as the proportion of alerts followed by clinical actions at the centers and the proportion of alerts fully managed remotely. Conclusions: During the lockdown, the system detected a significant drop in the median activity level and generated a higher rate of alerts suggestive of worsening of the HF status.
Keywords:
ICD; CRT; heart failure; remote monitoring; multisensor
