VIRTUAL CARE IN CARDIAC ELECTROPHYSIOLOGY HAS LASTING IMPACT AND IS USED MORE OFTEN COMPARED TO OTHER CARDIOVASCULAR SUBSPECIALTIES

ABSTRACT

Background: Following restrictions imposed by the Covid-19 pandemic, virtual care became frequently employed. The adoption and maintained utilization of virtual care in Cardiac Arrhythmia specialty compared to other parts of cardiology may be greater owing to the nature of the care being given. Objective: To assess digital health resource utilization over time in EP and non-EP providers. Methods: All patient appointments in our cardiovascular medicine clinics at our Center from March 2020 through November 2021 were analyzed. Completed appointments by EP and non-EP providers were categorized as Virtual (VV) or In-Person (IPV). Routine remote device transmissions were excluded from the analysis. The VV rate was defined as the number of VVs divided by total Visits (IPVs and VVs). Results: Over the 21-month observation period, a total of 23,052 VVs (37%) and 39,882 IPVs (63%) were completed. The monthly percentage of virtual visits ranged from 13.5% (N=454/3383) in November 2021 to 97.5% in April of 2020 (N=2123/2178). Compared to other cardiovascular subspecialties, EP had a consistently higher proportion of virtual visits that has persisted throughout the observation period (range 29%-98.4%). With regard to new visits only, in 2020 there were 395/735 (53.7%) new EP VVs vs. 1608/3523 45.6% Non-EP VVs (p<.01). This discrepancy widened in 2021 as there were 524/1353 (38.7%) of all new EP VVs vs. 1400/6181 (22.7%) of all new non-EP VVs. The same widening discrepancy was seen with return visits (RPV). RPVs in 2020 were 3155/4720 (66.8%) EP VVs vs. 9659/16516 (58.5%;p<.01). This discrepancy for RPVs also widened in 2021 as there were 2010/4662 (43.1%) of all RPV EP VVs vs. 4301/19607 (21.9%;p<.01) of all new non-EP VVs. (see attached figure). Conclusion: Cardiac electrophysiologists and arrhythmia patients have adopted and maintained virtual visits to a greater extent compared to other areas of cardiovascular medicine. This may reflect improved at home sensor use and outpatient monitors to facilitate virtual visits in EP. [Formula presented] [Formula presented]