Key result
The first COVID-19 pandemic wave was associated with a 52.2% reduction in EP procedures, 32.7% reduction in device procedures (P=.003), and 36.8% decrease in CRM referrals (P<.001).
Why the study?
The effects of the COVID-19 pandemic on cardiac rhythm management services remained poorly quantified.
Did the COVID-19 pandemic reduce the volume of cardiac rhythm management procedures and referrals in UK specialist centers?
Observational
Yes
Did the COVID-19 pandemic reduce the volume of cardiac rhythm management procedures and referrals in UK specialist centers?
The COVID-19 pandemic caused significant initial reductions in cardiac rhythm management procedures and referrals in the UK, with subsequent recovery and adaptation but leaving a substantial backlog.
Associated reductions suggest possible UK backlogs requiring mitigation; extends observational data on pandemic effects on EP and device volumes.
Background Effects of the COVID-19 pandemic on cardiac rhythm management (CRM) services remain poorly quantified. Objective To describe the impact of COVID-19 on specialist CRM centers in the United Kingdom (UK). Methods Two-center study involving the Liverpool Heart and Chest Hospital NHS Foundation Trust and Royal Papworth Hospital NHS Foundation Trust. The first nationwide lockdown lasted from April to July 2020 and the second from December 2020 to March 2021. Results Compared to the pre-pandemic period, pandemic 1 (April–July 2020) was associated with a 52.2% reduction in electrophysiology (EP) procedures ( P = .083), 32.7% reduction in device procedures ( P = .003), and 36.8% decrease in CRM referrals ( P < .001). There was also a 13.4% increase in the use of conscious sedation (CS) ( P < .001) and day-case procedures for EP ( P = .003), with no change in day-case device procedures ( P = .555). Corresponding numbers for pandemic 2 (August–November 2020) were a 0.7% increase in EP procedures ( P = .925), 7.9% reduction in device procedures ( P = .232), 13.9% decrease in referrals ( P = .014), 5.5% increase in CS for EP ( P = .009), 7.1% increase in day-case EP procedures ( P < .001), and no change in day-case device procedures ( P = .537). Corresponding numbers for pandemic 3 (December 2020–March 2021) were a 31.6% reduction in EP procedures ( P = .001), 22.3% reduction in device procedures ( P = .006), 8.4% decrease in referrals ( P = .094), 11.0% increase in CS for EP ( P < .001), 7.6% increase in day-case EP procedures ( P = .003), and no change in day-case device procedures ( P = .146). By the end of March 2021, the CRM waiting list was 167.8% pre-pandemic levels. Conclusion During the COVID-19 pandemic, specialist centers in the UK were affected such that the number of procedures performed was greatly reduced in the initial period with latter improvements as better coping strategies were developed.
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Ding et al. (2022) conducted an observational in Cardiac rhythm management (CRM) services. COVID-19 pandemic vs. pre-pandemic period was evaluated on Electrophysiology (EP) procedures during pandemic 1 (April-July 2020) (52.2% reduction, p=.083). The first COVID-19 pandemic wave was associated with a 52.2% reduction in EP procedures, 32.7% reduction in device procedures (P=.003), and 36.8% decrease in CRM referrals (P<.001).
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