A Comparison of Data Quality and Monitoring Completion Rates Between Clinic and Self-Applied ECG Patches.

BACKGROUND: Since the onset of the COVID-19 pandemic, direct-to-patient, self-applied ECG patch use has substantially increased. There are limited data comparing clinic versus self-applied ECG patches. OBJECTIVES: To compare rates of ECG patch return, percentages of time patches yielded analyzable data (analyzable time), and percentages of prescribed time ECG patches were worn between clinic and self-applied ECG patches prior to and during COVID-19. METHODS: A retrospective analysis of patients prescribed an ECG patch during "pre-COVID" (3/1/2019-3/1/2020) and "COVID" (4/1/2020-4/1/2021) years was conducted. ECG patch return rates, mean percentages of analyzable time, and mean percentages of prescribed wear time were compared between clinic and self-applied groups. RESULTS: Of 29,093 ECG patch prescriptions (19% COVID self-applied), the COVID self-applied group had a lower return rate (90.8%) than both clinic-applied groups (COVID; 97.1%; pre-COVID; 98.1%; p<0.001). Among the 28,048 ECG patches (17.5% self-applied) returned for analysis, the COVID self-applied group demonstrated a lower mean percentage of analyzable time (95.9 + 8.2%) than both clinic-applied groups (COVID: 96.6 + 6.6%; pre-COVID 96.6 + 7.4%; p<0.001). There were no differences in mean percentage of prescribed wear time between groups (pre-COVID clinic-applied: 96.7 + 34.3%; COVID clinic-applied 97.4 + 39.8%; COVID self-applied 98.1 + 52.1%, p=0.09). CONCLUSIONS: Self-applied ECG patches were returned at a lower rate and had a statistically lower percentage of analyzable time than clinic-applied patches. However, there were no differences between groups in mean percentages of prescribed wear time, and mean percentages of analyzable time were >95% in all groups.

Novel coronavirus 19 (COVID-19) associated sinus node dysfunction: a case series.

BACKGROUND: Novel coronavirus-19 disease (COVID-19) is associated with significant cardiovascular morbidity and mortality. To date, there have not been reports of sinus node dysfunction (SND) associated with COVID-19. This case series describes clinical characteristics, potential mechanisms, and short-term outcomes of COVID-19 patients who experience de novo SND. CASE SUMMARY: We present two cases of new-onset SND in patients recently diagnosed with COVID-19. Patient 1 is a 70-year-old female with no major past medical history who was intubated for acute hypoxic respiratory failure secondary to COVID-19 pneumonia and developed new-onset sinus bradycardia without a compensatory increase in heart rate in response to relative hypotension. Patient 2 is an 81-year-old male with a past medical history of an ascending aortic aneurysm, hypertension, and obstructive sleep apnoea who required intubation for COVID-19-induced acute hypoxic respiratory failure and exhibited new-onset sinus bradycardia followed by numerous episodes of haemodynamically significant accelerated idioventricular rhythm. Two weeks following the onset of SND, both patients remain in sinus bradycardia. DISCUSSION: COVID-19-associated SND has not previously been described. The potential mechanisms for SND in patients with COVID-19 include myocardial inflammation or direct viral infiltration. Patients diagnosed with COVID-19 should be monitored closely for the development of bradyarrhythmia and haemodynamic instability.