Impact of COVID-19 pandemic on the volume, cost, and outcomes of cardiac electrophysiology procedures in the United...

Area of Science:

• Cardiology
• Health Economics

Background:

• Professional societies advised delaying elective procedures during the COVID-19 pandemic to optimize resource allocation.
• Electrophysiology (EP) procedures are crucial for managing cardiac arrhythmias and heart failure.

Purpose of the Study:

• To analyze shifts in the utilization, cost, and outcomes of electrophysiology procedures in the U.S. during the COVID-19 pandemic.
• To quantify the financial and clinical impact of pandemic-related procedural changes.

Main Methods:

• Utilized the National Inpatient Sample database (2016-2020) to identify EP procedures via ICD-10 codes.
• Evaluated trends in EP procedure volume, associated costs/revenue, and in-hospital outcomes.

Main Results:

• EP procedure utilization declined significantly during the pandemic, with an estimated loss of 50,233 procedures and $7.06 billion in revenue in 2020.
• The decline was mainly driven by reduced dual-chamber permanent pacemaker (PPM) implantation, followed by ablation and implantable cardioverter-defibrillator procedures.
• Leadless PPM utilization increased by 9.4%, but EP device implantation showed a rise in adverse in-hospital events (9.4% vs. 8.0%).

Conclusions:

• The COVID-19 pandemic led to a substantial decrease in U.S. electrophysiology procedures, primarily affecting dual-chamber PPMs, ablations, and ICDs.
• Despite the overall decline, leadless PPMs saw increased utilization during the pandemic.
• EP device implantation during this period was linked to a higher incidence of adverse in-hospital events.