Home Monitoring trends during COVID-19 infection

Background: Cardiac implantable electronic device (CIED) recipients could have an unfavorable prognosis if infected with the novel coronavirus (COVID-19). We aimed to analyze the data daily transmitted by the Home Monitoring (HM) system (BIOTRONIK, Berlin, Germany) of CIEDs during the infection. Methods: We identified CIED patients followed with the HM who experienced COVID-19 clinical manifestations. The daily trends of the following HM variables were analyzed: mean heart rate (HR), physical activity, thoracic impedance (TI), ventricular and atrial arrhythmic burden. Results: The study cohort included 10 CIED patients (median age 90 [84-92] years, male 90%) with acute respiratory syndrome. The HR showed an increase of a value ranging from 10 to 30 bpm well in advance of the severe clinical manifestations. The physical activity was generally low during the entire infection course. The TI decreased in patients presented with pulmonary edema, but increased significantly (8 to 25 Ω) in most COVID-19 patients (8 out of 10) suggesting an association with pulmonary fibrosis. Arrhythmic complications were also found in half of the patients. Conclusion: The trends of HR and TI in CIEDs recipients infected by the COVID-19 often showed early recurrent patterns before adverse clinical manifestations.