New Guidance for Cardiac Electrophysiology During Pandemic Stresses Protective Measures

By Reuters Staff

April 13, 2020

NEW YORK (Reuters Health) - In keeping with national guidelines, new guidance on the practice of cardiac electrophysiology (EP) during the COVID-19 pandemic emphasizes social distancing, proper use of personal protective equipment and other measures.

Electrophysiologists should maintain a high degree of suspicion for COVID-19 in any patient they interact with in the EP lab, hospital, or outpatient setting, according to the new recommendations, issued by the Heart Rhythm Society, the American College of Cardiology and the American Heart Association.

Social distancing includes minimizing the number of individuals rounding in the hospital and limiting the time spent in the rooms of patients with suspected or confirmed COVID-19.

The guidance, copublished in Circulation and Heart Rhythm, also stresses that personal protective equipment (PPE) should be donned properly by all clinicians and healthcare providers in contact with patients with suspected COVID-19 infection.

To minimize contact with patients who might have COVID-19, nonurgent, elective procedures should be postponed or canceled, write Dr. Dhanunjaya R. Lakkireddy of the Kansas City Heart Rhythm Institute, in Overland Park, Kansas, and colleagues.

For urgent or emergent procedures, screening for COVID-19 should be performed where infection is suspected. In those cases, ideally, confirmation of COVID-19 test status should be awaited to avoid unnecessary utilization of resources, such as PPE.

The guidance provides lists of procedures that might be considered urgent or emergent, semi-urgent and nonurgent or elective.

In-person clinic visits should be avoided where possible and replaced by telehealth/virtual visits, and remote monitoring should be employed for EP patients whose devices allow it.

When CPR is necessary for a patient with confirmed or suspected COVID-19, the number of personnel in the room should be minimized, and all participants should don PPE prior to entering the room.

"At this unprecedented time, it is important that patients feel that physicians and healthcare systems are not abandoning them," the authors conclude. "While electrophysiology is uniquely suited to leverage virtual care and remote monitoring, it is important to assure patients that they have our full support, and we are ready and able to provide care as necessary."

Dr. Lakkireddy did not respond to a request for comments.

SOURCE: Circulation, online April 6, 2020.