Pandemic caused $7B in lost revenue from US electrophysiology procedures in 2020
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Key takeaways:
- In 2020, more than 50,000 projected electrophysiology procedures totaling more than $7 billion in revenue were lost due to the COVID-19 pandemic.
- The greatest effect was in the second quarter of 2020.
In the United States, the COVID-19 pandemic was associated with more than 50,000 lost electrophysiology procedures totaling more than $7 billion in revenue in 2020, researchers reported in HeartRhythm.
“During the COVID-19 pandemic, given the limited supply of personal protective equipment, many ... electrophysiological procedures were deferred or canceled,” Anas Hashem, MD, chief medical resident in the Internal Medicine Residency Program at Rochester General Hospital in Rochester, New York, told Healio. “We do not have enough national trends of electrophysiology (EP) procedures across the United States; therefore, we decided to use the national databases to analyze the sample to offer valuable perspectives of the impact of COVID-19 on EP procedures in the United States, aiding policymakers in making informed decisions as they navigate the challenges posed by the pandemic and formulate contingency plans for potential future pandemics.”
Hashem and colleagues analyzed National Inpatient Sample data of EP procedures conducted from 2016 to 2020.
Drop in procedures
During this period, the number of procedures peaked in the second quarter of 2019, at 298 cases per 1 million population, and was lowest in the second quarter of 2020, at 220 cases per 1 million population, according to the researchers.
Hashem and colleagues determined that, in 2020, the pandemic was associated with the loss of 50,233 procedures (39,337 devices and 10,896 ablations), which translates to a revenue loss of $7.06 billion.
The procedure categories with the biggest losses in 2020 were dual-chamber permanent pacemaker implantation (49.3% of lost cases, accounting for $2.88 billion), ablations (21.7% of lost cases, accounting for $1.84 billion) and implantable cardioverter defibrillator implantation (12% of lost cases, accounting for $1.36 billion), according to the researchers.
However, implantation of leadless pacemakers increased by 9.4% during the pandemic, the researchers wrote.
Partial recovery
“We expected a significant decrease in the EP procedures in the first year of the pandemic, surprisingly, in the third and fourth quarters of the year 2020, there was partial recovery and the only significant impact of COVID-19 on procedures was during the second quarter of 2020,” Hashem told Healio.
The rebound “can be explained by the immediate release of clear guidelines by [the American College of Cardiology, the American Heart Association and the Heart Rhythm Society] focusing on identifying procedures considered urgent/emergent that need to be prioritized when enduring limited resources,” he said, noting that measures to prevent the spread of the virus that causes COVID-19 and an increase in same-day hospital discharges also played a role.
“Our study offers valuable perspectives of the COVID-19 impact on EP procedures in the United States, aiding policymakers in making informed decisions as they navigate the challenges posed by the pandemic and formulate contingency plans for potential future pandemics,” Hashem said.
Compared with March to December 2019, the pandemic era of March to December 2020 was associated with increased rates of adverse in-hospital events for patients undergoing EP procedures (9.4% vs. 8%; P < .001), including in-hospital death, cardiac arrest, cardiogenic shock, acute MI, ischemic stroke and kidney injury requiring dialysis, the researchers found.
“During the pandemic, EP procedures were done on 1,615 COVID-19 positive cases, which could have contributed to the increased in-hospital mortality,” Hashem told Healio. “Also, multiple studies reported that COVID-19 itself is associated with an overall excess atrial fibrillation-related mortality in the United States.”
For more information:
Anas Hashem, MD, can be reached at anas.hashem@rochesterregional.org.
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