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.

1st Department of Medicine Cardiology University Medical Centre Mannheim Germany and German Center for Cardiovascular Research Partner Site Heidelberg Mannheim Mannheim Germany

2nd Department of Medicine Department of Cardiovascular Medicine 1st Faculty of Medicine Charles University Prague and General University Hospital Prague Prague Czech Republic

AP HP Sorbonne Université Institut de Cardiologie Hôpital Pitié Salpêtrière Paris France

Arrhythmia Section Department of Cardiology Hospital Universitari i Politècnic La Fe Instituto de Investigación Sanitaria La Fe Centro de Investigaciones Biomédicas en RED en Enfermedades Cardiovasculares Valencia Spain

Azienda Ospedaliero Universitaria Pisana Cardiothoracic and Vascular Department Cardiovascular Unit 2 Pisa Italy

Cardiac Electrophysiology and Pacing Unit Papa Giovanni XXIII Hospital Bergamo Italy

Cardiology Department Soroka University Medical Center Faculty of Health Sciences Ben Gurion University of the Negev Beer Sheva Israel

Cardiology Department Tel Aviv Sourasky Medical Center Sackler School of Medicine Tel Aviv University Tel Aviv Israel

Cardiology Division Department of Biomedical Metabolic and Neural Sciences University of Modena and Reggio Emilia Policlinico di Modena Modena Italy

Cardiology Unit ASST Fatebenefratelli Sacco Luigi Sacco University Hospital Milan Italy

Cardiology University Hospital Rangueil Toulouse France

Center for Arrhythmia Care Division of Cardiology Pritzker School of Medicine University of Chicago Medicine Chicago Illinois

Clinic of Cardiology and Arrhythmology University Hospital Ospedali Riuniti Department of Clinical Special and Dental Sciences Polytechnic University of Marche Ancona Italy

Department of Cardiology and Cardiovascular Research Institute Basel University Hospital Basel University of Basel Basel Switzerland

Department of Cardiology Dokkyo Medical University Saitama Medical Center Koshigaya Saitama Japan

Department of Cardiology Northwell Health Zucker School of Medicine at Hofstra Northwell Health South Shore University Hospital Bay Shore New York

Department of Cardiology S Maria dei Battuti Hospital AULSS 2 Veneto Conegliano Italy

Department of Medical Sciences Surgery and Neurosciences University of Siena Siena Italy and Azienda Ospedaliera Universitaria Senese Siena Italy

Division of Cardiac Electrophysiology Houston Methodist DeBakey Cardiology Associates Houston Texas

Division of Cardiology Department of Medical Sciences Città della Salute della Scienza Hospital University of Turin Turin Italy

Division of Cardiology Department of Medicine Vagelos College of Physicians and Surgeons New York Presbyterian Columbia University Irving Medical Center New York New York

Division of Cardiology University Hospital Ospedale Maggiore Parma Italy

Electrophysiology Unit Cardiology Department Carmel Medical Center Haifa Israel

Electrophysiology Unit Department of Cardiology Istituto Cardiocentro Ticino Lugano Switzerland

Heart Institute Hadassah University Hospital Jerusalem and Sackler School of Medicine Tel Aviv University Tel Aviv Israel

Henri Mondor University Hospital Cardiology Unit Creteil Paris France

Jesselson Integrated Heart Center Shaare Zedek Medical Center Faculty of Medicine Hebrew University Jerusalem Israel

Jesselson Integrated Heart Center Shaare Zedek Medical Center Jerusalem Faculty of Health Sciences Ben Gurion University of the Negev Beer Sheva Israel

Meir Medical Center Kfar Saba Israel

Ospedali Riuniti Padova Sud Madre Teresa di Calcutta Monselice Italy

Rabin Medical Center Petach Tikva Sackler School of Medicine Tel Aviv University Tel Aviv Israel

Thomas Jefferson University Hospital Philadelphia Pennsylvania

UCLA Cardiac Arrhythmia Center Los Angeles California

UMAE Hospital de Especialidades Dr Antonio Fraga Mouret CMN La Raza IMSS CDMX Mexico City México

Heart Rhythm. 2022 Feb;19(2):217-218. doi: 10.1016/j.hrthm.2021.11.008. PubMed

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World Health Organization Coronavirus Disease (COVID-19) https://www.who.int/publications/m/item/weekly-epidemiological-update-on-covid-19---11-may-2021 Weekly Epidemiological Update—May 11 2021. Published May 11, 2021. Accessed May 11, 2021. Available at:

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