PO-697-06 INTERVENTIONAL ELECTROPHYSIOLOGY IN THE AMBULATORY SURGICAL CENTER DURING SARS-COV-2 PANDEMIC

Abstract

The SARS-CoV-2 pandemic has resulted in major disruptions of patient care due to suspension or cancellation of elective hospital procedures. In response, the Center for Medicare and Medicaid Services (CMS) created the Hospitals Without Walls program and authorized Ambulatory Surgical Centers (ASC) to provide services as a hospital. Demonstrate how our first-in-nation dedicated ASC in cardiac electrophysiology was able to perform therapeutic procedures in patients with arrhythmias throughout the pandemic. The ASC consists of 4,961 square feet, with 2 procedure rooms equipped with imaging and 3D mapping systems and 6 recovery room beds. Patients with cardiac arrhythmias were evaluated in the outpatient office, had pre-admission labs including COVID-19 testing and were discharged on the same day of their intervention. This prospective study group consists of 1686 procedures in 1070 patients. A TEE/ Cardioversion was performed in 208. Device implantation was performed in 552 (Pacemakers:156, Defibrillators:70, Bi-Ventricular devices: 49). Radiofrequency Ablation (RFA) was done in 1134 patients (Supraventricular Tachycardia:374, Atrial Fibrillation:662, Ventricular tachycardia:180). Complications resulting in patients requiring hospital admission occurred in 4 patients (Protamine reaction in 1 patient, Pericardial Effusion in 1 patient and groin hematoma in 2 patients) During the continued pandemic, the ASC has provided an alternative non-hospital setting for patients with cardiac arrhythmias who require invasive procedures. As a novel concept in the health care delivery of patient with cardiac arrhythmias, a specialized ASC in cardiac electrophysiology can successfully and safely treat patients in a non-hospital and lower cost environment.