Performance of Electrophysiology Procedures at an Academic Medical
Center Amidst the 2020 Coronavirus (COVID-19) Pandemic
Abstract
A global coronavirus (COVID-19) pandemic occurred at the start of 2020
and is already responsible for more than 74,000 deaths worldwide, just
over 100 years after the influenza pandemic of 1918. At the center of
the crisis is the highly infectious and deadly SARS-CoV-2, which has
altered everything from individual daily lives to the global economy and
our collective consciousness. Aside from the pulmonary manifestations of
disease, there are likely to be several electrophysiologic (EP) sequelae
of COVID-19 infection and its treatment, due to consequences of
myocarditis and the use of QT-prolonging drugs. Most crucially, the
surge in COVID-19 positive patients that have already overwhelmed the
New York City hospital system requires conservation of hospital
resources including personal protective equipment (PPE), reassignment of
personnel, and reorganization of institutions, including the EP
laboratory. In this proposal, we detail the specific protocol changes
that our EP department has adopted during the COVID-19 pandemic,
including performance of only urgent/emergent procedures,
afterhours/7-day per week laboratory operation, single attending-only
cases to preserve PPE, appropriate use of PPE, telemedicine and video
chat follow-up appointments, and daily conferences to collectively
manage the clinical and ethical dilemmas to come. We discuss also
discuss how we perform EP procedures on presumed COVID positive and
COVID tested positive patients in order to highlight issues that others
in the EP community may soon face in their own institution as the virus
continues to spread nationally and internationally.