CANADIAN ELECTROPHYSIOLOGY LABS REGISTRY REPORT UPDATE 2011-2018

Abstract

Interventional cardiac electrophysiology (EP) is a rapidly evolving field; a nationwide registry was established and re-administered since 2011 to conduct a periodic review of resource allocation across Canada. A retrospective questionnaire was designed to collect data regarding EP laboratory infrastructure, imaging, human resources, procedural volumes, and wait times. Leading physicians from each EP lab were contacted electronically; participation was voluntary. Each survey collected data over two calendar years. All existing Canadian EP centres were identified (29 in 2011, 31 in 2018); 50% and 45% of active centres participated in the last two instalments of the registry. Since the registry’s inception in 2011, data has been consistently obtained from 11 centres. All eleven centres are university-affiliated. The number of full time physicians ranges between one and seven, (mean of 4 per centre). Table 1 reports trends in procedural volumes and operators. The mean wait time to see an electrophysiologist for an initial non-urgent consult is 23 weeks. The wait time between an EP consult and ablation date is 17.8 weeks for a simple ablation, 15.9 weeks for a VT ablation, and 30.1 weeks for an AF ablation. On average centres have two (range: 1-4) rooms equipped for ablations; each centre uses facilities an average of seven daily shifts per week. While diagnostic studies and radiofrequency ablations are performed in all centres, point-by-point cryoablation is available in 85% and cryoballoon in 77% of the centres; 23% and 15% of the respondents use PVAC and NMARQ technology respectively. Two centres actively use remote magnetic navigation systems. CARTO and intracardiac echo are the most commonly utilized 3D mapping systems in 11 (85%) centres, followed by EnSite-NavX Velocity in nine (69%), EnSite-NavX Precision in 7 (54%), Mediguide in two (15%) centres, Rhythmia and LocaLisa are used in one centre each. Philips is the most widely used imaging system in 85% of centres, followed by Siemens in 54% centres. Non-3D tracing systems were operated by technicians in 23% of the centers in 2016, up from 50% in 2011. Industry representatives are increasingly operating 23% of the tracing systems up from 11% in 2011. This initiative provides contemporary information on invasive electrophysiology lab practices. The results show a feasibility in ongoing data collection which will serve as a reference for decisions regarding the needs of laboratories and research planning. This data provides basic benchmarks of national resources and may assist local resource planning.