Impact of the Covid-19 Pandemic on Electrophysiology Procedural Volume in the United States: A Nationwide Analysis

ABSTRACT

Background: The COVID-19 pandemic has had an unprecedented impact on the United States health system and its ability to deliver care. In particular, surgical and interventional procedures suffered a significant decline in the early stages of the pandemic for a multitude of reasons including, PPE and personnel shortages, the deference of elective procedures, and governmental bans on elective procedures. The impact of these factors on electrophysiology (EP) procedural rates in the United States is unknown. Objective(s) To study the impact of the COVID-19 pandemic on EP procedural volume in the United States (2019-2020). Method(s) We analyzed the National inpatient sample (2019-2020) to identify hospitalizations involving EP procedures using ICD-10-PCS codes. Weighted analysis was performed to determine the number of procedures performed on a monthly basis. The US census data was employed to ascertain procedure rates per million population, the trends of which are displayed in Figure 1. Result(s) A total of 236,991 EP procedures were performed in 2020 - a 9% decrease from 2019 (n= 260,615). This included an annualized 11.25% decrease in device implantations (ICD and PPM), a 7.7% drop in AF ablations, and a 5.4% decrease in VT ablations as compared to 2019. Interestingly rates of left atrial appendage occlusion (LAAO) procedures saw an annualized 3.7% increase in 2020. The maximal per-month decline in procedural volume was noted in April 2020. An overall decline of 48% in EP procedures was noted, with the most precipitous drop with LAAO (90%), followed by AF Ablation (65%), PPM (4.3%), ICD (3.8%), and least with VT ablation (2.5%). Conclusion(s) The COVID-19 pandemic has had a significant and heterogonous impact on EP procedural volume. Despite a precipitous 48% decline in April 2020, overall, 2020 procedure rates have recovered to a 9% drop from 2019. [Formula presented]Copyright © 2023