Background: Catheter ablation procedures for atrial fibrillation (AF)
were significantly curtailed during the peak of coronavirus disease 2019
(COVID-19) pandemic to conserve healthcare resources and limit exposure.
There is little data regarding peri-procedural outcomes of medical
procedures during the COVID-19 pandemic. We enacted protocols to safely
reboot AF ablation while limiting healthcare resource utilization.
Objective: To evaluate acute and subacute outcomes of protocols
instituted for reboot of AF ablation during the COVID-19 pandemic.
Methods: Perioperative healthcare utilization and acute procedural
outcomes were analyzed for consecutive patients undergoing AF ablation
under COVID-19 protocols (2020 cohort; n=111) and compared to those of
patients who underwent AF ablation during the same time period in 2019
(2019 cohort; n=200). Newly implemented practices included pre-operative
COVID-19 testing, selective transesophageal echocardiography (TEE),
utilization of venous closure, and same-day discharge when clinically
appropriate. Results: Pre-ablation COVID-19 testing was positive in 1 of
111 patients. There were 0 cases ablation-related COVID-19 transmission,
and 0 major complications in either cohort. Pre-procedure TEE was
performed in significantly fewer 2020 cohort patients compared to the
2019 cohort patients (68.4% vs. 97.5%, p <0.001,
respectively) despite greater prevalence of persistent arrhythmia in the
2020 cohort. Same day discharge was achieved in 68% of patients in the
2020 cohort, compared to 0% of patients in the 2019 cohort.
Conclusions: Our findings demonstrate safe resumption of complex
electrophysiology procedures during the COVID-19 pandemic, reducing
healthcare utilization and maintaining quality of care. Protocols
instituted may be generalizable to other types of procedures and