Risk of COVID-19 infection after cardiac electrophysiology procedures

• Main Authors: Virginia Workman, MD, James V. Freeman, MD, Edinrin R. Obasare, MBBS, Shashank Jain, MD, Raj Ganeshan, MD, Alicia Burr, APRN, MSN, Mark Blitzer, MD, Joseph Akar, MD, Rachel Lampert, MD, FHRS
• Format: Article
• Language: English
• Published: Elsevier 2020-10-01
• Series: Heart Rhythm O2
• Subjects: Ablation; Coronavirus; Electrophysiology; Implantation; Nosocomial transmission
• Online Access: http://www.sciencedirect.com/science/article/pii/S266650182030115X

Background: During the COVID-19 pandemic, attempts to conserve resources and limit virus spread have resulted in delay of nonemergent procedures across all medical specialties, including cardiac electrophysiology (EP). Many patients have delayed care and continue to express concerns about potential nosocomial spread of coronavirus. Objective: To quantify risk of development of COVID-19 owing to in-hospital transmission related to an EP procedure, in the setting of preventive measures instituted in our laboratory areas. Methods: We contacted patients by telephone who underwent emergent procedures in the electrophysiology lab during the COVID-19 surge at our hospital (March 16, 2020, to May 15, 2020, reaching daily census 450 COVID-19 patients,) ≥2 weeks after the procedure, to assess for symptoms of and/or testing for COVID-19, and assessed outcomes from medical record review. Results: Of the 124 patients undergoing EP procedures in this period, none had developed documented or suspected coronavirus infection. Seven patients described symptoms of chest pain, dyspnea, or fever; 3 were tested for coronavirus and found to be negative. Of the remaining 4, 2 had a more plausible alternative explanation for the symptoms, and 2 had transient symptoms not meeting published criteria for probable COVID-19 infection. Conclusion: Despite a high hospital census of COVID-19 patients during the period of hospital stay for an EP procedure, there were no likely COVID-19 infections occurring in follow-up of at least 2 weeks. With proper use of preventive measures as recommended by published guidelines, the risk of nosocomial spread of COVID-19 to patients in the EP lab is low.