Prolonged care delivery time and reduced rate of electrophysiological procedures during the lockdown period due to Covid-19 outbreak

Expert Rev Med Devices. 2021 May;18(5):493-498. doi: 10.1080/17434440.2021.1926985. Epub 2021 May 24.

Abstract

Objectives: The aim of this study is to demonstrate how Electrophysiology activity has been impacted by the pandemic Coronavirus disease 2019 (COVID-19).

Methods: In this multicenter retrospective study, we analyze all consecutive patients admitted for electrophysiological procedures during the COVID-19 lockdown in the Tuscany region of Italy, comparing them to patients hospitalized in the corresponding period of the previous year.

Results: The impact of COVID-19 on cardiac arrhythmia management was impressive, with a reduction of more than 50% in all kinds of procedures. A gender gap was observed, with a more relevant reduction for female patients. Arrhythmic urgencies requiring a device implant showed a reduced time from symptoms to first medical contact but the time from first medical contact to procedure was significantly prolonged.

Conclusion: Hospitals need to consider how outbreaks may affect health systems beyond the immediate infection. Routine activity should be based on a risk assessment between the prompt performance of procedure and its postponement. Retrospective observational analysis such as this study could be decisive in evidence-based medicine of any future pathogen outbreak.Nonstandard Abbreviations and Acronyms PM= pacemakerICD= implantable cardioverter defibrillatorECV= electrical cardioversionEPS= electrophysiological studyAP= ablations proceduresCIED= cardiac implantable electronic devicesWCD= wearable cardioverter defibrillatorEP Lab= Electrophysiology LaboratoriesAVNRT =atrioventricular nodal reentry tachycardiaAVRT= atrioventricular reentry tachycardiaAFL= atrial flutterAF= atrial fibrillationVT= ventricular tachycardiaAT= atrial tachycardia.

Keywords: Virus; arrhythmia; disease management; epidemiology; healthcare.

Publication types

  • Multicenter Study

MeSH terms

  • Aged
  • Arrhythmias, Cardiac / physiopathology
  • COVID-19 / epidemiology*
  • Defibrillators, Implantable
  • Delivery of Health Care*
  • Disease Outbreaks*
  • Electrophysiologic Techniques, Cardiac*
  • Female
  • Humans
  • Italy / epidemiology
  • Male
  • Pacemaker, Artificial
  • Pandemics
  • Retrospective Studies
  • SARS-CoV-2
  • Time Factors