• Giuseppe Boriani, Federico Guerra, Roberto De Ponti, Antonio D'Onofrio, Michele Accogli, Matteo Bertini, Giovanni Bisignani, Giovanni Battista Forleo, Maurizio Landolina, Carlo Lavalle, Pasquale Notarstefano, Renato Pietro Ricci, Gabriele Zanotto, Pietro Palmisano, and for AIAC Ricerca Network Investigators.
• Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, Via del Pozzo 71, 41121, Modena, Italy. giuseppe.boriani@unimore.it.
• Intern Emerg Med. 2023 Jan 1; 18 (1): 137149137-149.

BackgroundThe subsequent waves of the COVID-19 pandemic in Italy had a major impact on cardiac care.MethodsA survey to evaluate the dynamic changes in arrhythmia care during the first five waves of COVID-19 in Italy (first: March-May 2020; second: October 2020-January 2021; third: February-May 2021; fourth: June-October 2021; fifth: November 2021-February 2022) was launched.ResultsA total of 127 physicians from arrhythmia centers (34% of Italian centers) took part in the survey. As compared to 2019, a reduction in 40% of elective pacemaker (PM), defibrillators (ICD), and cardiac resynchronization devices (CRT) implantations, with a 70% reduction for ablations, was reported during the first wave, with a progressive and gradual return to pre-pandemic volumes, generally during the third-fourth waves, slower for ablations. For emergency procedures (PM, ICD, CRT, and ablations), recovery from the initial 10% decline occurred in most cases during the second wave, with some variability. However, acute care for atrial fibrillation, electrical cardioversions, and evaluations for syncope showed a prolonged reduction of activity. The number of patients with devices which started remote monitoring increased by 40% during the first wave, but then the adoption of remote monitoring declined.ConclusionsThe dramatic and profound derangement in arrhythmia management that characterized the first wave of the COVID-19 pandemic was followed by a progressive return to the volume of activities of the pre-pandemic periods, even if with different temporal dynamics and some heterogeneity. Remote monitoring was largely implemented during the first wave, but full implementation is needed.© 2022. The Author(s), under exclusive licence to Società Italiana di Medicina Interna (SIMI).

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