Cardiac operations and interventions during the COVID-19 pandemic: a nationwide perspective

AIMS: The COVID-19 pandemic has led to a decline in hospitalizations for non-COVID-19-related conditions. We explored the impact of the COVID-19 pandemic on cardiac operations and interventions undertaken in England. METHODS AND RESULTS: An administrative database covering hospital activity for England, the Health Episodes Statistics, was used to assess a total of 286 697 hospitalizations for cardiac operations and interventions, as well as 227 257 hospitalizations for myocardial infarction (MI) and 453 799 for heart failure (HF) from 7 January 2019 to 26 July 2020. Over the 3 months of 'lockdown', total numbers and mean reductions in weekly rates n (-%), compared with the same time period in 2019, were: coronary artery bypass grafting -2507 (-64%); percutaneous coronary intervention -5245 (-28%); surgical -1324 (-41%) and transcatheter -284 (-21%) aortic valve replacement; mitral valve replacement; implantation of pacemakers -6450 (-44%), cardiac resynchronization therapy with -356 (-42%) or without -491 (-46%) defibrillation devices, and implantable cardioverter-defibrillators -501 (-45%); atrial fibrillation ablation -1902 (-83%), and other ablations -1712 (-64%) (all P < 0.001). Over this period, there were 21 038 fewer procedures than in the reference period in 2019 (P < 0.001). These changes paralleled reductions in hospitalizations for MI -10 794 (-27%) and HF -63 058 (-28%) (both P < 0.001). CONCLUSIONS: The COVID-19 pandemic has led to substantial reductions in the number of cardiac operations and interventions undertaken. An alternative strategy for healthcare delivery to patients with cardiac conditions during the COVID-19 pandemic is urgently needed.