Risk of COVID-19 infection after cardiac electrophysiology procedures

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. Many patients have delayed care and continue to express concerns about potential nosocomial spread of coronavirus. Objective To quantify risk of development of COVID19 due to in-hospital transmission related to an electrophysiology 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 COVID19 surge at our hospital (3/16/2020 to 5/15/2020, reaching daily census 450 COVID19 patients,) > two 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. 7 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 COVID19 infection. Conclusion Despite a high hospital census of COVID-19 patients during the period of hospital stay for an electrophysiology procedure, there were no likely COVID-19 infections occurring in follow up of at least two weeks. With proper use of preventive measures as recommended by published guidelines, the risk of nosocomial spread of COVID-19 to patients in the electrophysiology lab is low.
Graphical abstract