BACKGROUND: COVID-19 was temporally associated with an increase in out-of-hospital cardiac arrests, but the underlying mechanisms are unclear. We sought to determine if patients with implantable defibrillators residing in areas with high COVID-19 activity experienced an increase in defibrillator shocks during the COVID-19 outbreak. METHODS AND RESULTS: Using the Medtronic (Mounds View, MN) Carelink database from 2019 and 2020, we retrospectively determined the incidence of implantable defibrillator shock episodes among patients residing in New York City, New Orleans, LA, and Boston, MA. A total of 14 665 patients with a Medtronic implantable defibrillator (age, 66±13 years; and 72% men) were included in the analysis. Comparing analysis time periods coinciding with the COVID-19 outbreak in 2020 with the same periods in 2019, we observed a larger mean rate of defibrillator shock episodes per 1000 patients in New York City (17.8 versus 11.7, respectively), New Orleans (26.4 versus 13.5, respectively), and Boston (30.9 versus 20.6, respectively) during the COVID-19 surge. Age-and sex-adjusted hurdle model showed that the Poisson distribution rate of defibrillator shocks for patients with ≥1 shock was 3.11 times larger (95% CI, 1.08–8.99; P=0.036) in New York City, 3.74 times larger (95% CI, 0.88– 15.89; P=0.074) in New Orleans, and 1.97 times larger (95% CI, 0.69–5.61; P=0.202) in Boston in 2020 versus 2019. However, the binomial odds of any given patient having a shock episode was not different in 2020 versus 2019. CONCLUSIONS: Defibrillator shock episodes increased during the higher COVID-19 activity in New York City, New Orleans, and Boston. These observations may provide insights into COVID-19–related increase in cardiac arrests.
Bibliographical noteFunding Information:
Authors are grateful to Jeff D. Lande, PhD, for validating the statistical methods. This article is partially the result of work supported with resources and use of facilities of the Minneapolis VA Health Care System. The contents do not represent the views of the US Department of Veterans Affairs or the US Government.
Dr Adabag has received research grants from Medtronic. Drs Cheng, Zimmerman, and Black are employees of Medtronic. The remaining authors have no disclosures to report.
© 2021 The Authors.
- Implantable cardioverter-defibrillator
- cardiac arrest
PubMed: MeSH publication types
- Journal Article
- Research Support, Non-U.S. Gov't