The COVID-19 challenge to cardiac electrophysiologists: optimizing resources at a referral center
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The COVID-19 challenge to cardiac electrophysiologists: optimizing resources at a referral center Patrizio Mazzone 1 & Giovanni Peretto 1 & Andrea Radinovic 1 & Luca Rosario Limite 1 & Alessandra Marzi 1 & Simone Sala 1 & Manuela Cireddu 1 & Pasquale Vegara 1 & Francesca Baratto 1 & Gabriele Paglino 1 & Giuseppe D’Angelo 1 & Lorenzo Cianfanelli 1 & Savino Altizio 1 & Felicia Lipartiti 1 & Antonio Frontera 1 & Caterina Bisceglia 1 & Simone Gulletta 1 & Paolo Della Bella 1 Received: 6 April 2020 / Accepted: 23 April 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose To describe how a referral center for cardiac electrophysiology (EP) rapidly changed to comply with the ongoing COVID-19 healthcare emergency. Methods We present retrospective data about the modification of daily activities at our EP unit, following the pandemic outbreak of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in Italy. In particular, in the context of a preexisting “hub-and-spoke” network, we describe how procedure types and volumes have changed in the last 3 months. Results Since our institution was selected as a COVID-19 referral center, the entire in-hospital activity was reorganized to assist more than 1000 COVID-positive cases. Only urgent EP procedures, including ventricular tachycardia ablation and extraction of infected devices, were both maintained and optimized to meet the needs of external hospitals. In addition, most of the non-urgent EP procedures were postponed. Finally, following prompt internal reorganization, both outpatient clinics and on-call services underwent significant modification, by integrating telemedicine support whenever applicable. Conclusion We presented the fast reorganization of an EP referral center during the ongoing COVID-19 healthcare emergency. Our hub-and-spoke model may be useful for other centers, aiming at a cost-effective management of resources in the context of a global crisis. Keywords Coronavirus . COVID-19 . SARS-CoV-2 . Electrophysiology . Arrhythmology . Hub and spoke
1 Introduction Severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) pneumonia is a newly recognized illness that, following the first outbreak in China, rapidly spreads around the world [1].The World Health Organization (WHO) declared coronavirus disease 2019 (COVID-19) as a public health emergency of international concern on March 11, 2020. The clinical spectrum of COVID-19 in Italy ranged from mild to
Patrizio Mazzone and Giovanni Peretto contributed equally to this work. * Giovanni Peretto [email protected] 1
Department of Cardiac Electrophysiology and Arrhythmology, IRCCS San Raffaele Scientific Institute, Vita-Salute University and San Raffaele Hospital, Via Olgettina 60, 20132 Milan, Italy
critical cases, with lethality variability across regions, being higher in Northern Italy, in a possible association with atmospheric pollution [2]. While public health is promoting any measure to limit the transmission of the disease, in-hospital daily cl
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