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. 2021 Sep 15;12(9):4688-4698.
doi: 10.19102/icrm.2021.120903. eCollection 2021 Sep.

Impact of Coronavirus Disease 2019 on Cardiac Arrhythmia Care: Experience of a Spanish Tertiary Hospital During the Health Crisis Triggered by the First Wave of the Pandemic

Adolfo Fontenla  1   2 , Daniel Rodríguez-Muñoz  1   2 , Luis Borrego-Bernabé  1   2 , Isabel Montilla-Padilla  1   2 , Álvaro Marco Del Castillo  1   2 , Javier Ramos  1   2 , Ana Isabel Fernández-Arranz  1   2 , María López-Gil  1   2 , Fernando Arribas  1   2   3   4 , Rafael Salguero-Bodes  1   2   3   4
Affiliations

Impact of Coronavirus Disease 2019 on Cardiac Arrhythmia Care: Experience of a Spanish Tertiary Hospital During the Health Crisis Triggered by the First Wave of the Pandemic

Adolfo Fontenla et al. J Innov Card Rhythm Manag. .

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.

Keywords: Arrhythmia unit; COVID-19; cardiac electrophysiology; coronavirus; health management.

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Conflict of interest statement

The authors report no conflicts of interest for the published content.

Figures

Figure 1:
Figure 1:
Weekly activity of the arrhythmia unit clinics (left axis) in “in person” and telehealth modalities, in the context of the epidemic situation through the number of new confirmed COVID-19 infections in the region of Madrid (right axis). Data sourced from the Carlos III Health Institute.
Figure 2:
Figure 2:
Activity of “in person” and “telehealth” clinics of the arrhythmia unit (expressed as absolute numbers and as percentages) in the previous eight weeks and during the eight weeks of the COVID-19 outbreak.
Figure 3:
Figure 3:
Weekly activity of the electrophysiology rooms (left axis) depending on the type of patient (urgent hospitalized, planned inpatient activity, and DH) in the context of the epidemic situation through the number of new confirmed COVID-19 infections in the region of Madrid (right axis). Data sourced from the Carlos III Health Institute.
Figure 4:
Figure 4:
Activity of the electrophysiology rooms according to the type of patient (urgent hospitalized, planned inpatient activity, and DH) expressed as absolute numbers of procedures and as percentages, in the previous eight weeks and during the eight weeks of the COVID-19 outbreak.
Supplementary Figure 1:
Supplementary Figure 1:
Postoperative COVID-19 follow-up questionnaire.
See this image and copyright information in PMC

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