Priority II. Equivocal
Equivocal procedures and scenarios should ideally be postponed. There may be rare circumstances where a compelling reason exists if there is an intermediate chance for short-term benefit due to a substantial non-mortality risk, such as rehospitalization. Preventing rehospitalization is a reasonable goal to decrease risk of infection via social distancing. These should likely only be considered where the prevalence of COVID-19 is low and hospitals do not have shortages of intensive care unit beds and mechanical ventilators. Structured follow-up for patients with procedures put on hold is essential.
Catheter ablation for antiarrhythmic-refractory persistent rapid atrial fibrillation with heart failure and recent recurrent hospitalizations, particularly possible tachycardia-induced cardiomyopathy, is a situation that may be considered non-elective. Conversely, catheter ablation for amiodarone-refractory ischemic ventricular tachycardia with mild-to-moderate symptoms that terminated with antitachycardia pacing has a class I recommendation11, but may be elective.