Implantation of cardiac electronic devices in active COVID-19 patients: Results from an international survey

Oholi Tovia-Brodie, Moshe Rav Acha, Bernard Belhassen, Alessio Gasperetti, Marco Schiavone, Giovanni Battista Forleo, Milton E Guevara-Valdivia, David Valdeolivar Ruiz, Nicolas Lellouche, David Hamon, Davide Castagno, Matteo Bellettini, Gaetano M De Ferrari, Mikael Laredo, Jean-Baptiste Carvès, Barbara Ignatiuk, Giampaolo Pasquetto, Paolo De Filippo, Giovanni Malanchini, Behzad B PavriCraig Raphael, Luigi Rivetti, Roberto Mantovan, Jason Chinitz, Melissa Harding, Giuseppe Boriani, Edoardo Casali, Elaine Y Wan, Angelo Biviano, Carlos Macias, Stepan Havranek, Pietro Enea Lazzerini, Antonio M Canu, Marco Zardini, Giulio Conte, Óscar Cano, Michela Casella, Boris Rudic, Alexander Omelchenko, Nilesh Mathuria, Gaurav A Upadhyay, Asaf Danon, Arie Lorin Schwartz, Philippe Maury, Shiro Nakahara, Gustavo Goldenberg, Nicolas Schaerli, Sergiy Bereza, Angelo Auricchio, Michael Glikson, Yoav Michowitz

Research output: Contribution to journalArticlepeer-review

6 Citations (Scopus)


BACKGROUND: Cardiac implantable electronic device (CIED) implantation rates as well as the clinical and procedural characteristics and outcomes in patients with known active coronavirus disease 2019 (COVID-19) are unknown.

OBJECTIVE: The purpose of this study was to gather information regarding CIED procedures during active COVID-19, performed with personal protective equipment, based on an international survey.

METHODS: Fifty-three centers from 13 countries across 4 continents provided information on 166 patients with known active COVID-19 who underwent a CIED procedure.

RESULTS: The CIED procedure rate in 133,655 hospitalized COVID-19 patients ranged from 0 to 16.2 per 1000 patients (P <.001). Most devices were implanted due to high-degree/complete atrioventricular block (112 [67.5%]) or sick sinus syndrome (31 [18.7%]). Of the 166 patients in the study survey, the 30-day complication rate was 13.9% and the 180-day mortality rate was 9.6%. One patient had a fatal outcome as a direct result of the procedure. Differences in patient and procedural characteristics and outcomes were found between Europe and North America. An older population (76.6 vs 66 years; P <.001) with a nonsignificant higher complication rate (16.5% vs 7.7%; P = .2) was observed in Europe vs North America, whereas higher rates of critically ill patients (33.3% vs 3.3%; P <.001) and mortality (26.9% vs 5%; P = .002) were observed in North America vs Europe.

CONCLUSION: CIED procedure rates during known active COVID-19 disease varied greatly, from 0 to 16.2 per 1000 hospitalized COVID-19 patients worldwide. Patients with active COVID-19 infection who underwent CIED implantation had high complication and mortality rates. Operators should take these risks into consideration before proceeding with CIED implantation in active COVID-19 patients.

Original languageEnglish
Pages (from-to)206-216
Number of pages11
JournalHeart Rhythm
Issue number2
Publication statusPublished - Feb 2022

Bibliographical note

Copyright © 2021 Heart Rhythm Society. All rights reserved.


  • Aged
  • Atrioventricular Block/epidemiology
  • COVID-19/diagnosis
  • Comorbidity
  • Defibrillators, Implantable/statistics & numerical data
  • Female
  • Global Health/statistics & numerical data
  • Humans
  • Infection Control/instrumentation
  • Male
  • Middle Aged
  • Mortality
  • Outcome Assessment, Health Care
  • Pacemaker, Artificial/statistics & numerical data
  • Postoperative Complications/diagnosis
  • Prosthesis Implantation/adverse effects
  • Risk Factors
  • SARS-CoV-2/isolation & purification
  • Sick Sinus Syndrome/epidemiology
  • Surveys and Questionnaires


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