Electrophysiology in the time of coronavirus: coping with the great wave

Abstract

Aims To chart the effect of the COVID-19 pandemic on the activity of interventional electrophysiology services in affected regions. Methods and results We reviewed the electrophysiology laboratory records in three affected cities: Wenzhou in China, Milan in Italy, and London in the UK. We inspected catheter lab records and interviewed electrophysiologists in each centre to gather information on the impact of the pandemic on working patterns and on the health of staff members and patients. There was a striking decline in interventional electrophysiology activity in each of the centres. The decline occurred within a week of the recognition of widespread community transmission of the virus in each region and shows a striking correlation with the national figures for new diagnoses of COVID-19 in each case. During the period of restriction, workflow dropped to <5% of normal, consisting of emergency cases only. In two of three centres, electrophysiologists were redeployed to perform emergency work outside electrophysiology. Among the centres studied, only Wenzhou has seen a recovery from the restrictions in activity. Following an intense nationwide programme of public health interventions, local transmission of COVID-19 ceased to be detectable after 18 February allowing the electrophysiology service to resume with a strict testing regime for all patients. Conclusion Interventional electrophysiology is vulnerable to closure in times of great social difficulty including the COVID-19 pandemic. Intense public health intervention can permit suppression of local disease transmission allowing resumption of some normal activity with stringent precautions.

One-Year Recording of Cardiac Arrhythmias in a Non-Infected Population with Cardiac Implantable Devices During the COVID-19 Pandemic

“…Therefore, we recommend RFCA for patients with paroxysmal AF in cases of frequent arrhythmia recurrence in another unpredictable pandemic. Especially in another national lockdowns where individuals are asked to remain isolated in their homes to stop the spread of the disease, electrophysiologists are redeployed to perform emergency work outside electrophysiology, elective work was canceled, and cases were performed only in emergencies, 27 and protect patients from the severe complication of AF, such as embolism and stroke.…”

Impacto de la pandemia COVID19 en la práctica de la electrofisiología cardíaca en Latinoamérica: Una encuesta de la Sociedad Latinoamericana del Ritmo Cardíaco

“…Hubo un descenso muy importante de todos los tipos de procedimientos invasivos (77%) (tabla 3). El descenso en las ablaciones fue similar a lo ocurrido en algunas ciudades de Europa y China en que también fue analizado (7) . Las pocas ablaciones que se siguieron haciendo allí fueron principalmente de urgencia o emergencia, lo mismo que encontramos en esta encuesta (tabla 4) (7) .…”

“…El descenso en las ablaciones fue similar a lo ocurrido en algunas ciudades de Europa y China en que también fue analizado (7) . Las pocas ablaciones que se siguieron haciendo allí fueron principalmente de urgencia o emergencia, lo mismo que encontramos en esta encuesta (tabla 4) (7) . Esto explica porque el implante de marcapasos pasó a tener una importancia relativa mayor en el total de procedimientos durante la pandemia.…”

Electrophysiology and Interventional Cardiology Procedure Volumes During the Coronavirus Disease 2019 Pandemic

“…Li et al evaluated EP procedural volumes at 3 centers during a surge of COVID 19 in China, Italy and United Kingdom. 13 In all three centers, all elective EP procedures were cancelled with an overall volume being <5% of normal volumes. In addition, all EP personnel were deployed for delivering emergency care out of EP.…”