Abstract
The coronavirus disease 2019 (COVID-19) pandemic has resulted in a deep restructuring of cardiovascular care, especially in the setting of cardiac arrhythmia units, which are characterized by a wide variety of clinical and interventional activities. We describe the experience of a large university hospital deeply hit during the COVID-19 health crisis (first outbreak of the pandemic), focusing on the exceptional measures implemented and their impact in terms of outcomes. We performed a retrospective study comparing the human and structural resources and the activity of a cardiac arrhythmia unit in a Spanish tertiary hospital for two consecutive periods: from January 12, 2020, to March 8, 2020 (“pre-COVID stage”), and from March 9, 2020, to May 2, 2020 (“COVID stage”). Data were contextualized within the number of confirmed COVID-19 cases in the region of Madrid. The measures implemented were promotion of non–face-to-face consultations, selection of urgent procedures, design of a “COVID-free” circuit for outpatient interventions, and protocolization for patients with COVID-19. A total of 3,526 consultations and 362 procedures were performed. During the COVID stage, the number of consultations remained stable, and the electrophysiology rooms’ activity decreased by 55.2% with a relative increase in the number of urgent-hospitalized cases attended (11.8% COVID-19-positive patients). The electrophysiology rooms’ activity returned to “normal” in the last week of the COVID stage, with no contagion being detected among patients or professionals. In conclusion, the measures implemented allowed us to respond safely and efficiently to the health care needs of patients with arrhythmias during the COVID-19 crisis and may be useful for other institutions facing similar situations.
Highlights
During the last two years, the novel severe acute respiratory syndrome coronavirus 2, has spread worldwide, triggering a health crisis unprecedented in recent history
The pre-COVID stage was based on a team of four fulltime electrophysiologists, two electrophysiology fellows, The Journal of Innovations in Cardiac Rhythm Management, September 2021
During the first weeks of this stage, two nurses and one nursing assistant had to take sick leave and required home isolation as a consequence of COVID-19 presumably not acquired at work
Summary
During the last two years, the novel severe acute respiratory syndrome coronavirus 2, has spread worldwide, triggering a health crisis unprecedented in recent history. Transmitted through respiratory droplets, this virus is capable of causing coronavirus disease 2019 (COVID-19), sometimes producing severe and even fatal symptoms.[1] Old age, hypertension, obesity, diabetes, and cardiovascular diseases are risk factors for severe COVID-19,2 affecting the majority of patients seen in cardiology departments. All non-urgent activity of clinics, diagnostic tests, daytime hospitalization, scheduled admissions, and surgical interventions were suspended, directly impacting the organization of the arrhythmia units (as well as other intervention-based health care services). Adapting the activity of these units to the new scenario poses a challenge due to the high prevalence, mortality, and disability rates caused by cardiac arrhythmias and the need to address rhythm disorders in hospitalized patients with COVID-19
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