ABSTRACT
Since December 2019, the coronovirus disease-2019 (COVID-19) pandemic has resulted in more than 2,160,000 positive cases and more than 145,000 deaths until April 18, 2020. The pressure to the health services worldwide has been unprecedented. The redeployment of staff and resources to treat more efficiently COVID-19 cases along with the need to reduce disease transmission has affected the field of electrophysiology among many others. Amendments to clinical pathways are obligatory in this perspective to continue to provide the necessary health services to the people who need them, although at the same time, infection control and prevention are not compromised by inadvertent disease transmission or unnecessary use of resources. We aim to provide a guide of the logistic aspects of electrophysiology procedures derived from our tertiary cardiac center during the current COVID-19 pandemic.
Subject(s)
Cardiac Electrophysiology , Coronavirus Infections , Critical Pathways/trends , Pandemics , Patient Care Management , Pneumonia, Viral , Betacoronavirus/isolation & purification , COVID-19 , Cardiac Electrophysiology/methods , Cardiac Electrophysiology/organization & administration , Cardiac Electrophysiology/trends , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Coronavirus Infections/therapy , Humans , Infection Control/methods , Infection Control/organization & administration , Organizational Innovation , Pandemics/prevention & control , Patient Care Management/methods , Patient Care Management/organization & administration , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , Pneumonia, Viral/therapy , SARS-CoV-2 , Tertiary Care Centers/organization & administration , United KingdomABSTRACT
COVID-19 is a rapidly evolving public health emergency that has largely impacted the provision of healthcare services around the world. The challenge for electrophysiology teams is double; on one side preventing disease spread by limiting all nonessential face-to-face interactions, but at the same time ensuring continued care for patients who need it. These guidelines contain recommendations regarding triaging in order to define what procedures, device checks and clinic visits can be postponed during the pandemic. We also discuss best practices to protect patients and healthcare workers and provide guidance for the management of COVID-19 patients with arrhythmic conditions.
Subject(s)
Arrhythmias, Cardiac/surgery , Catheter Ablation/statistics & numerical data , Coronavirus Infections/prevention & control , Delivery of Health Care , Electrophysiologic Techniques, Cardiac/standards , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Practice Guidelines as Topic , Argentina , Arrhythmias, Cardiac/diagnosis , Brazil , COVID-19 , Cardiac Electrophysiology/organization & administration , Catheter Ablation/standards , Colombia , Coronavirus Infections/epidemiology , Elective Surgical Procedures/standards , Elective Surgical Procedures/statistics & numerical data , Electrophysiologic Techniques, Cardiac/statistics & numerical data , Female , Humans , Infection Control/organization & administration , Latin America , Male , Mexico , Pandemics/statistics & numerical data , Pneumonia, Viral/epidemiology , Safety Management/standards , Societies, MedicalABSTRACT
The coronavirus disease 2019 crisis is a global pandemic of a novel infectious disease with far-ranging public health implications. With regard to cardiac electrophysiology (EP) services, we discuss the "real-world" challenges and solutions that have been essential for efficient and successful (1) ramping down of standard clinical practice patterns and (2) pivoting of workflow processes to meet the demands of this pandemic. The aims of these recommendations are to outline: (1) essential practical steps to approaching procedures, as well as outpatient and inpatient care of EP patients, with relevant examples, (2) successful strategies to minimize exposure risk to patients and clinical staff while also balancing resource utilization, (3) challenges related to redeployment and restructuring of clinical and support staff, and (4) considerations regarding continued collaboration with clinical and administrative colleagues to implement these changes. While process changes will vary across practices and hospital systems, we believe that these experiences from 4 different EP sections in a large New York City hospital network currently based in the global epicenter of the coronavirus disease 2019 pandemic will prove useful for other EP practices adapting their own practices in preparation for local surges.