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July 21, 20260 citations

Incarceration and Electrophysiology Care: A Review of Clinical, Ethical, and Systems-Level Challenges.

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SHSean HalloranAKAnthony KalousdianWWWilliam Weber

Key Result

Incarceration disrupts the delivery of cardiac electrophysiology care due to structural, financial, and logistical constraints, likely resulting in care that falls below community standards.

Key Points

  • This review aims to explore how incarceration affects the delivery of cardiac electrophysiology care and identify barriers and improvement opportunities.
  • Conducted a narrative review of literature related to incarceration, cardiovascular disease, and electrophysiology care.
  • Electrophysiology care quality is compromised by lack of continuity, specialized diagnostics, and procedural access.
  • Incarceration creates significant structural, financial, and logistical challenges for receiving heart rhythm care.
  • The review underscores a growing need for coordinated initiatives to enhance access to electrophysiology care for incarcerated populations.

Structured PICO

P
Population
Incarcerated individuals with or at risk for cardiovascular disease requiring electrophysiology care
E
Exposure
Delivery of cardiac electrophysiology care in carceral systems

Electrophysiology care in incarcerated populations is understudied and likely falls below community standards, requiring coordinated policy and health system initiatives to ensure equitable access.

Abstract

BACKGROUND: Incarcerated individuals bear a disproportionate burden of cardiovascular disease and face significant barriers to specialty care, including in cardiac electrophysiology. The impact of incarceration on electrophysiology care remains underrecognized and incompletely characterized. OBJECTIVE: To characterize how incarceration disrupts the delivery of cardiac electrophysiology care, identify clinical and system-level barriers, and propose opportunities to improve access and quality. METHODS: We conducted a narrative review of the literature on incarceration, cardiovascular disease, and electrophysiology care. RESULTS: High-quality EP care depends on care continuity, specialized diagnostics, procedural access, and longitudinal device and medication management - features that conflict with the structural, financial, and logistical constraints of incarceration. This review describes healthcare delivery in carceral systems, highlights the unique vulnerability of heart rhythm care in these environments, and identifies opportunities to improve access and quality. CONCLUSION: Electrophysiology care in incarcerated populations is understudied and likely falls below community standards. As the incarcerated population ages, demand for quality EP care will grow. Addressing this gap will require coordinated policy, health system, and research initiatives to ensure equitable access to EP care for incarcerated and formerly incarcerated individuals.

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Cite This Study

Halloran et al. (2026) conducted a review in Cardiovascular disease and electrophysiology care in incarcerated individuals. Incarceration was evaluated. Incarceration disrupts the delivery of cardiac electrophysiology care due to structural, financial, and logistical constraints, likely resulting in care that falls below community standards.

synapsesocial.com/papers/6a5f0bc586a4235cc161964chttps://doi.org/10.1016/j.hrthm.2026.07.020
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