The influence of the 2020 COVID-19 pandemic on the implantation rates of cardiac implantable electronic devices in Germany: changes between 2020 Q1–Q3 and 2019 Q1–Q3

Abstract

Abstract Aims During the early phase of the COVID-19 pandemic, hospital admissions for several medical and surgical conditions declined. Few data are available with respect to elective cardiac implantable electronic device (CIED) implantation. The aim of the present study was to determine the impact of the COVID-19 pandemic on the monthly CIED implantation rates in Germany (January-September 2020 vs. 2019). Methods and results The monthly rates of CIED implantation for the 2019 pre- and 2020 pandemic periods were retrieved from the Institute für das Entgeltsystem im Krankenhaus using German Operation and Procedure Classification codes to identify pacemakers (PMs), implantable cardioverter/defibrillators (ICDs), and cardiac resynchronization therapy (CRT) systems. Compared with 2019, the COVID-19 pandemic was associated with an overall decline of CIED implantation rates of −2.6%, reaching −22.9% in April 2020. Stratified by device type, the patterns of implantation were similar between PMs and ICDs, with maximal declines of −24.3% and −23.2% in April, respectively. Thereafter, the implantation rates gradually increased before stabilizing to rates similar to those observed in 2019. CRT implantation rates also declined in the early pandemic wave, but the overall 2020 rates increased by +4.3% likely driven by an increase of +16.5% (June–September). All the observed percentage differences of monthly device type related implantation rates demonstrated a statistical significance. Conclusion The COVID-19 pandemic had a significant impact on the implantation of CIEDs in Germany. A differential pattern of resource utilization was observed with a catch-up effect for PMs and ICDs. The implantation rates of CRT systems also declined, but they increased rapidly and remained higher than those of 2019.