Structured Abstract
Background: Catheter ablation procedures for atrial
fibrillation (AF) were significantly curtailed during the peak of
coronavirus disease 2019 (COVID-19) pandemic to conserve healthcare
resources and limit exposure. There is little data regarding
peri-procedural outcomes of medical procedures during the COVID-19
pandemic. We enacted protocols to safely reboot AF ablation while
limiting healthcare resource utilization.
Objective: To evaluate acute and subacute outcomes of protocols
instituted for reboot of AF ablation during the COVID-19 pandemic.
Methods: Perioperative healthcare utilization and acute
procedural outcomes were analyzed for consecutive patients undergoing AF
ablation under COVID-19 protocols (2020 cohort; n=111) and compared to
those of patients who underwent AF ablation during the same time period
in 2019 (2019 cohort; n=200). Newly implemented practices included
pre-operative COVID-19 testing, selective transesophageal
echocardiography (TEE), utilization of venous closure, and same-day
discharge when clinically appropriate.
Results: Pre-ablation COVID-19 testing was positive in 1 of 111
patients. There were 0 cases ablation-related COVID-19 transmission, and
0 major complications in either cohort. Pre-procedure TEE was performed
in significantly fewer 2020 cohort patients compared to the 2019 cohort
patients (68.4% vs. 97.5%, p <0.001, respectively) despite
greater prevalence of persistent arrhythmia in the 2020 cohort. Same day
discharge was achieved in 68% of patients in the 2020 cohort, compared
to 0% of patients in the 2019 cohort.
Conclusions: Our findings demonstrate safe resumption of
complex electrophysiology procedures during the COVID-19 pandemic,
reducing healthcare utilization and maintaining quality of care.
Protocols instituted may be generalizable to other types of procedures
and settings.