ABSTRACT
[Figure: see text].
Subject(s)
Arrhythmias, Cardiac/epidemiology , COVID-19/epidemiology , Global Health/trends , Aged , Arrhythmias, Cardiac/mortality , Arrhythmias, Cardiac/physiopathology , Arrhythmias, Cardiac/therapy , COVID-19/mortality , COVID-19/therapy , Cardiac Electrophysiology/trends , Comorbidity , Electrophysiologic Techniques, Cardiac/trends , Female , Health Care Surveys , Healthcare Disparities , Humans , Incidence , Male , Middle Aged , Practice Patterns, Physicians'/trends , Prevalence , Prognosis , Retrospective Studies , Risk Assessment , Time FactorsABSTRACT
INTRODUCTION: The coronavirus disease 2019 (COVID-19) pandemic has resulted in a significant decrease in volume of electrophysiology (EP) procedures. There has been concern that trainees may not achieve the procedural numbers required to graduate as independent electrophysiologists within the usual timeline. We sought to determine the impact of the COVID-19 pandemic on the percentage of clinical cardiac EP (CCEP) fellows in jeopardy of not meeting procedural volume requirements and overall sentiments regarding preparedness of fellows for independent practice. METHODS: We surveyed CCEP fellows and program directors about baseline procedural volumes, curriculum changes due to the pandemic, and attitudes about preparedness for board examinations and independent practice. RESULTS: Ninety-nine fellows and 27 program directors responded to the survey. Ninety-eight percent of responding fellows reported a decrease in procedural volume as a result of the pandemic. Program directors reported an overall decrease in annual number of ablations and device procedures performed by each fellow during the 2019-2020 academic year compared to the preceding year. Despite this, a minority of fellows and program directors reported concerns about meeting Accreditation Council for Graduate Medical Education procedural requirements for devices (9% and 4%, respectively) and ablation (19% and 9%) or preparedness for independent practice after a 2-year fellowship. CONCLUSIONS: The COVID-19 pandemic has resulted in a decrease in procedural volume for CCEP trainees, but the majority of fellows and program directors do not anticipate major barriers to timely graduation. This may change with COVID-19 resurgence and further interruptions in training.
Subject(s)
COVID-19 , Cardiac Electrophysiology/education , Cardiologists/education , Education, Medical, Graduate , Electrophysiologic Techniques, Cardiac , Adult , Cardiac Electrophysiology/trends , Cardiologists/trends , Clinical Competence , Curriculum , Education, Medical, Graduate/trends , Electrophysiologic Techniques, Cardiac/trends , Female , Humans , Male , Middle Aged , Surveys and Questionnaires , Time Factors , WorkloadABSTRACT
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
An increase in coronavirus disease (COVID-19) infections prompted Level 4 lockdown throughout New Zealand from 25 March 2020. We have investigated trends in coronary and electrophysiology (EP) procedures before and during this lockdown. The number of acute procedures for ST elevation myocardial infarction remained stable. In contrast, the number of in-patient angiograms and percutaneous intervention procedures fell by 53% compared with the previous 4 weeks in 2020 and by 56% compared with the corresponding period in 2019. Further study is required to determine the reasons for these trends.
Subject(s)
Cardiology Service, Hospital , Coronavirus Infections , Infection Control/statistics & numerical data , Pandemics , Percutaneous Coronary Intervention , Pneumonia, Viral , ST Elevation Myocardial Infarction , Betacoronavirus , COVID-19 , Cardiac Electrophysiology/methods , Cardiac Electrophysiology/trends , Cardiology Service, Hospital/organization & administration , Cardiology Service, Hospital/statistics & numerical data , Coronary Angiography/statistics & numerical data , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Female , Hospitalization/statistics & numerical data , Humans , Infection Control/methods , Infection Control/organization & administration , Male , Middle Aged , New Zealand/epidemiology , Pandemics/prevention & control , Percutaneous Coronary Intervention/methods , Percutaneous Coronary Intervention/statistics & numerical data , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , SARS-CoV-2 , ST Elevation Myocardial Infarction/epidemiology , ST Elevation Myocardial Infarction/therapy , Workload/statistics & numerical dataABSTRACT
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.