Electrophysiology Practice during the COVID-19 Pandemic: A New York Tertiary Hospital Experience

Anca, Diana; Reyes, Olivia; Mitra, Raman Lala; Epstein, Laurence; Shore-Lesserson, Linda

As hospitals became overwhelmed during the Covid-19 pandemic in March-May in New York, Cardiology and Electrophysiology (EP) departments rapidly developed protocols for case selection as well modifying the practice of managing the cases. This process involved applying the American Heart Association (AHA) and Heart Rhythm Society (HRS) Guidelines for triaging the cases based on acuity, postponing the elective cases and modifying the way Cardiac Implantable Electronic Devices (CIEDs) interrogation. Procedural revisions were necessary for the workflow in the electrophysiology laboratory and that involved modifying the EP suite to accommodate a Covid procedure room, a decontamination equipment area and repurposed room for recovery in the context of personnel (EP attendings and fellows) and the main recovery area being diverted to Covid-19 ICU. The anesthesiology team had an integral and essential role in this process. This article describes in detail the collaborative planning, preparation and implementation of electrophysiology practice at one of the major tertiary centers in New York. It describes the type of EP procedures performed during mid-March to mid-May at this center, the decision process in case selection, anesthetic management and outcomes and the comparison with the previous year. Recommendations by the AHA/HRS as well as American Society of Anesthesiology (ASA) were considered in the multidisciplinary collaborative approach to patient care and personnel safety.