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. 2020 Apr 21;10.1097/HPC.0000000000000225.
doi: 10.1097/HPC.0000000000000225. Online ahead of print.

Restructuring Electrophysiology During the COVID-19 Pandemic: A Practical Guide From a New York City Hospital Network

Free PMC article

Restructuring Electrophysiology During the COVID-19 Pandemic: A Practical Guide From a New York City Hospital Network

Geoffrey A Rubin et al. Crit Pathw Cardiol. .
Free PMC article


The COVID-19 crisis is a global pandemic of a novel infectious disease with far-ranging public health implications. With regard to cardiac electrophysiology (EP) services, we discuss the "real-world" challenges and solutions that have been essential for efficient and successful (i) ramping down of standard clinical practice patterns and (ii) pivoting of workflow processes to meet the demands of this pandemic. The aims of these recommendations are to outline: (1) essential practical steps to approaching procedures, as well as outpatient and inpatient care of EP patients, with relevant examples, (2) successful strategies to minimize exposure risk to patients and clinical staff while also balancing resource utilization, (3) challenges related to redeployment and restructuring of clinical and support staff, and (4) considerations regarding continued collaboration with clinical and administrative colleagues in order to implement these changes. While process changes will vary across practices and hospital systems, we believe that these experiences from four different EP sections in a large New York city hospital network currently based in the global epicenter of the COVID-19 pandemic will prove useful for other EP practices adapting their own practices in preparation for local surges.

Conflict of interest statement

S.K. reports institutional research grants from Edwards Lifesciences, Medtronic, and Abbott, consulting fees from Abbott, Admedus, and Meril Lifesciences, and equity options from Biotrace Medical and Thubrikar Aortic Valve Inc. A.K. reports Institutional funding to Columbia University and/or Cardiovascular Research Foundation from Medtronic, Boston Scientific, Abbott Vascular, Abiomed, CSI, Philips, ReCor Medical. Personal: CME program honoraria and travel/meal reimbursements only. A.B reports serving as a medical advisory board member for Boston Scientific and Biosense Webster.


Figure 1.
Figure 1.
Discussion points for regular daily communication between the hospital and EP leadership. It is important to troubleshoot clinical and administrative challenges and understand the broader balance of hospital needs with EP division resources during dynamic workflow changes.

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