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Electrophysiology in the time of coronavirus: coping with the great wave
Jia Li1, Patrizio Mazzone2, Lisa W M Leung3
1Department of Cardiology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, No.109 Xueyuan West Road, Lucheng District, Wenzhou 325000, Zhejiang, China.
Insights
The COVID-19 pandemic severely impacted interventional electrophysiology services, causing a drastic decline in procedures. Public health interventions helped suppress local transmission, allowing services to resume with strict precautions.
Area of Science:
- Cardiology
- Public Health
Background:
- The COVID-19 pandemic presented unprecedented challenges to healthcare systems globally.
- Interventional electrophysiology services are crucial for managing complex cardiac arrhythmias.
Purpose of the Study:
- To assess the impact of the COVID-19 pandemic on interventional electrophysiology services in affected regions.
- To understand the changes in working patterns and the health of staff and patients during the pandemic.
Main Methods:
- A review of electrophysiology laboratory records from Wenzhou (China), Milan (Italy), and London (UK).
- Inspection of catheter lab records and interviews with electrophysiologists.
- Correlation of activity decline with national COVID-19 case numbers.
Main Results:
- A significant decline in interventional electrophysiology activity was observed in all three cities, closely following the rise in COVID-19 cases.
- Workflow dropped to less than 5% of normal during restrictions, limited to emergency procedures.
- Electrophysiologists were redeployed to emergency roles in two of the three centers.
Conclusions:
- Interventional electrophysiology services are highly vulnerable during pandemics and social difficulties.
- Intense public health interventions are effective in controlling local disease transmission.
- Stringent precautions enable the resumption of electrophysiology services post-pandemic, as demonstrated in Wenzhou.
Aims:
To chart the effect of the COVID-19 pandemic on the activity of interventional electrophysiology services in affected regions.
Methods And Results:
We reviewed the electrophysiology laboratory records in three affected cities: Wenzhou in China, Milan in Italy, and London in the UK. We inspected catheter lab records and interviewed electrophysiologists in each centre to gather information on the impact of the pandemic on working patterns and on the health of staff members and patients. There was a striking decline in interventional electrophysiology activity in each of the centres. The decline occurred within a week of the recognition of widespread community transmission of the virus in each region and shows a striking correlation with the national figures for new diagnoses of COVID-19 in each case. During the period of restriction, workflow dropped to <5% of normal, consisting of emergency cases only. In two of three centres, electrophysiologists were redeployed to perform emergency work outside electrophysiology. Among the centres studied, only Wenzhou has seen a recovery from the restrictions in activity. Following an intense nationwide programme of public health interventions, local transmission of COVID-19 ceased to be detectable after 18 February allowing the electrophysiology service to resume with a strict testing regime for all patients.
Conclusion:
Interventional electrophysiology is vulnerable to closure in times of great social difficulty including the COVID-19 pandemic. Intense public health intervention can permit suppression of local disease transmission allowing resumption of some normal activity with stringent precautions.
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