ABSTRACT
Background: The COVID-19 pandemic accelerated adoption of a telehealth model to replace outpatient visits. We studied quality indicators and clinical outcomes associated with virtual visits in comparison to in-person ambulatory visits for patients with atrial fibrillation (AF) seen by electrophysiology providers. Methods: Quality indicators and outcomes for patients with primary diagnosis of AF seen by electrophysiology providers (6 physicians and 4 nurse practitioners) for the 12 week period of March 22-June 13, 2020 were compared with those from the 12 week period of March 24-June 15, 2019. Result: We identified 2340 clinic visits for AF (1081 in 2019 and 1259 in 2020). Telehealth was not used in 2019, and was used in 90.5% of the 2020 visits. On multivariate analysis during 120 days following each encounter, there was no difference in hospital admissions between 2019 and 2020 (OR 0.89;95% CI 0.69-1.14;p=0.3624), and there was trend towards lower emergency department visits in 2020 compared with 2019 (OR 0.77;95% CI 0.6-1;p=0.0509). There were 36 deaths at 120 days, mortality was similar in 2020 as compared with 2019 (OR 1.5;95% CI 0.74-3.03;p=0.2601). There was no difference in completed procedures including permanent pacemakers, cardiac resynchronization therapy devices, implantable cardioverter-defibrillators and catheter ablations. There was a significant difference in anticoagulant (OR 0.71;95% CI 0.52-0.99;p=0.0412) and antiarrhythmic (OR 0.78;95% CI 0.61-0.99;p=0.0384) dose adjustment or new prescriptions in 2019 compared with 2020. Conclusion: Telehealth was associated with similar intermediate-term clinical outcomes when compared to traditional ambulatory encounters. However, adjusting or providing new prescriptions for anticoagulant or antiarrhythmic medications was more common with in-person than with virtual visits.