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. 2023 Mar;4(3):193-199.
doi: 10.1016/j.hroo.2022.12.005. Epub 2022 Dec 21.

Contemporary trends in cardiac electrophysiology procedures in the United States, and impact of a global pandemic

Monte Scott  1 , Tina Baykaner  2 , T Jared Bunch  1 , Jonathan P Piccini  3 , Andrea M Russo  4 , Wendy S Tzou  5 , Emily P Zeitler  6 , Benjamin A Steinberg  1
Affiliations

Contemporary trends in cardiac electrophysiology procedures in the United States, and impact of a global pandemic

Monte Scott et al. Heart Rhythm O2. 2023 Mar.

Abstract

Background: There are limited data on trends in nationwide cardiac electrophysiology (EP) procedures in the United States before and during the global COVID-19 pandemic.

Objective: We aimed to understand contemporary EP procedural trends and how the COVID-19 pandemic impacted them.

Methods: Trends were obtained from publicly reported Centers for Medicare and Medicaid Services data from 2013 to 2020 (latest available). Rates of catheter-based EP procedures (EP studies and ablations) and cardiac implantable electronic device (CIED) procedures were analyzed. All procedural rates were calculated per 100,000 Medicare beneficiaries (year specific). Procedure physician subspecialty was also reported.

Results: From 2013 to 2019, annual rate of all cardiac EP procedures increased from 817.91 to 1089.68 per 100,000 beneficiaries. Catheter-based EP procedures increased from 323.73 to 675.01, while CIED rates decreased from 494.18 to 414.67. While all ablation procedures increased over time, relative proportion of ablation procedures being pulmonary vein isolation (PVI) increased (9.9% of ablations in 2013, to 18.2% in 2019). In 2020, rates of both catheter-based EP procedures and CIED procedures decreased; however, PVI share of ablation continued to increase in 2020 comprising 25.2% of ablation procedures.

Conclusion: Rates of EP procedures have increased among Medicare beneficiaries, with catheter-based procedures now eclipsing CIEDs. Additionally, a greater proportion of catheter-based EP procedures are PVI, but they still represent a minority of all ablations. In 2020, rates of EP procedures were attenuated, yet the proportion of PVI ablations increased to over one-fourth of ablation procedures. These data have important implications for the EP workforce.

Keywords: Ablation; Electrophysiology; Implantable devices; Medicare; Procedure trends.

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Figures

Figure 1
Figure 1
Trend in number of electrophysiology (EP) studies and ablations vs cardiac implantable electronic device (CIED) implantations per 100,000 Medicare beneficiaries in the years 2013–2020.
Figure 2
Figure 2
Trend in percentage of pulmonary vein isolation (PVI) procedures vs non-PVI procedures for all electrophysiology studies (EPSs) or ablations in the years 2013–2020.
Figure 3
Figure 3
Trends in number of supraventricular tachycardia (SVT), pulmonary vein isolation (PVI), and ventricular tachycardia (VT) ablation procedures per 100,000 Medicare beneficiaries in the years 2013–2020.
Figure 4
Figure 4
Trend in number of implantable cardioverter-defibrillators (ICDs) vs permanent pacemakers (PPMs) per 100,000 Medicare beneficiaries in the years 2013–2020. These trends of PPM and ICD do not sum into the cardiac implantable electronic device procedural group, as there are other procedures within this group (ie, nonspecific lead changes).
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References

    1. Go A.S., Hylek E.M., Phillips K.A., et al. Prevalence of diagnosed atrial fibrillation in adults: national implications for rhythm management and stroke prevention: the AnTicoagulation and Risk Factors in Atrial Fibrillation (ATRIA) study. JAMA. 2001;285:2370–2375. - PubMed
    1. Kirchhof P., Camm A.J., Goette A., et al. Early rhythm-control therapy in patients with atrial fibrillation. N Engl J Med. 2020;383:1305–1316. - PubMed
    1. Andrade J.G., Deyell M.W., Macle L., et al. Progression of atrial fibrillation after cryoablation or drug therapy. N Engl J Med. 2022 Nov 7 [E-pub ahead of print] - PubMed
    1. Faryan M., Buchta P., Kowalski O., et al. Temporal trends in the availability and efficacy of catheter ablation for atrial fibrillation and atrial flutter in a highly populated urban area. Kardiol Pol. 2020;78:537–544. - PubMed
    1. Foo F.S., Stiles M.K., Lee M., et al. Ten year trends in cardiac implantable electronic devices in New Zealand: a national data linkage study (ANZACS-QI 51) Intern Med J. 2022;52:614–622. - PubMed