Cardiac electrophysiology consultative experience at the epicenter of the COVID-19 pandemic in the United States.
AAD, Antiarrhythmic drug
AF, Atrial fibrillation
Arrhythmia
CIED, Cardiac implantable electronic device
COVID-19
COVID-19, Coronavirus disease 2019
CRT-D, Cardiac resynchronization therapy defibrillator
Coronavirus
Electrophysiology
ICD, Implantable cardioverter defibrillator
IRB, Institutional review board
PPE, Personal protective equipment
SARS-CoV-2, Severe acute respiratory syndrome coronavirus 2
Journal
Indian pacing and electrophysiology journal
ISSN: 0972-6292
Titre abrégé: Indian Pacing Electrophysiol J
Pays: Netherlands
ID NLM: 101157207
Informations de publication
Date de publication:
Historique:
received:
04
06
2020
revised:
21
07
2020
accepted:
24
08
2020
pubmed:
31
8
2020
medline:
31
8
2020
entrez:
31
8
2020
Statut:
ppublish
Résumé
The COVID-19 pandemic has greatly altered the practice of cardiac electrophysiology around the world for the foreseeable future. Professional organizations have provided guidance for practitioners, but real-world examples of the consults and responsibilities cardiac electrophysiologists face during a surge of COVID-19 patients is lacking. In this observational case series we report on 29 consecutive inpatient electrophysiology consultations at a major academic medical center in New York City, the epicenter of the pandemic in the United States, during a 2 week period from March 30-April 12, 2020, when 80% of hospital beds were occupied by COVID-19 patients, and the New York City metropolitan area accounted for 10% of COVID-19 cases worldwide. Reasons for consultation included: Atrial tachyarrhythmia (31%), cardiac implantable electronic device management (28%), bradycardia (14%), QTc prolongation (10%), ventricular arrhythmia (7%), post-transcatheter aortic valve replacement conduction abnormality (3.5%), ventricular pre-excitation (3.5%), and paroxysmal supraventricular tachycardia (3.5%). Twenty-four patients (86%) were positive for COVID-19 by nasopharyngeal swab. All elective procedures were canceled, and only one urgent device implantation was performed. Thirteen patients (45%) required in-person evaluation and the remainder were managed remotely. Our experience shows that the application of a massive alteration in workflow and personnel forced by the pandemic allowed our team to efficiently address the intersection of COVID-19 with a range of electrophysiology issues. This experience will prove useful as guidance for emerging hot spots or areas affected by future waves of the pandemic.
Sections du résumé
BACKGROUND
BACKGROUND
The COVID-19 pandemic has greatly altered the practice of cardiac electrophysiology around the world for the foreseeable future. Professional organizations have provided guidance for practitioners, but real-world examples of the consults and responsibilities cardiac electrophysiologists face during a surge of COVID-19 patients is lacking.
METHODS
METHODS
In this observational case series we report on 29 consecutive inpatient electrophysiology consultations at a major academic medical center in New York City, the epicenter of the pandemic in the United States, during a 2 week period from March 30-April 12, 2020, when 80% of hospital beds were occupied by COVID-19 patients, and the New York City metropolitan area accounted for 10% of COVID-19 cases worldwide.
RESULTS
RESULTS
Reasons for consultation included: Atrial tachyarrhythmia (31%), cardiac implantable electronic device management (28%), bradycardia (14%), QTc prolongation (10%), ventricular arrhythmia (7%), post-transcatheter aortic valve replacement conduction abnormality (3.5%), ventricular pre-excitation (3.5%), and paroxysmal supraventricular tachycardia (3.5%). Twenty-four patients (86%) were positive for COVID-19 by nasopharyngeal swab. All elective procedures were canceled, and only one urgent device implantation was performed. Thirteen patients (45%) required in-person evaluation and the remainder were managed remotely.
CONCLUSION
CONCLUSIONS
Our experience shows that the application of a massive alteration in workflow and personnel forced by the pandemic allowed our team to efficiently address the intersection of COVID-19 with a range of electrophysiology issues. This experience will prove useful as guidance for emerging hot spots or areas affected by future waves of the pandemic.
Identifiants
pubmed: 32861812
pii: S0972-6292(20)30092-9
doi: 10.1016/j.ipej.2020.08.006
pmc: PMC7450949
pii:
doi:
Types de publication
Journal Article
Langues
eng
Pagination
250-256Informations de copyright
© 2020 Indian Heart Rhythm Society. Production and hosting by Elsevier B.V.
Déclaration de conflit d'intérêts
The authors have no relevant conflicts of interest to report.
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