COVID-19 大流行对中国导管消融术的影响：时空分析。

Impact of COVID-19 pandemic on catheter ablation in China: A spatiotemporal analysis.

机构信息

Arrhythmia Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

National Center for Cardiovascular Quality Improvement Committee, Fuwai Hospital, Beijing, China.

出版信息

Front Public Health. 2022 Nov 23;10:1027926. doi: 10.3389/fpubh.2022.1027926. eCollection 2022.

DOI:10.3389/fpubh.2022.1027926

PMID:36504945

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9727188/

Abstract

BACKGROUND

The COVID-19 pandemic has significantly impacted routine cardiovascular health assessments and services. We aim to depict the temporal trend of catheter ablation (CA) and provide experience in dealing with the negative impact of the COVID-19 pandemic.

METHODS

Data on CA between January 2019, and December 2021, were extracted from the National Center for Cardiovascular Quality Improvement platform. CA alterations from 2019 to 2021 were assessed with a generalized estimation equation.

RESULTS

A total of 347,924 patients undergoing CA were included in the final analysis. The CA decreased remarkably from 122,839 in 2019 to 100,019 (-18.58%, 95% CI: -33.40% to -3.75%, = 0.02) in 2020, and increased slightly to 125,006 (1.81%, 95% CI: -7.01% to 3.38%, = 0.49) in 2021. The CA experienced the maximal reduction in February 2020 (-88.78%) corresponding with the peak of monthly new COVID-19 cases and decreased by 54.32% (95%CI: -71.27% to -37.37%, < 0.001) during the 3-month lockdown and increased firstly in June 2020 relative to 2019. Since then, the CA in 2020 remained unchanged relative to 2019 (-0.06%, 95% CI: -7.01% to 3.38%, = 0.98). Notably, the recovery of CA in 2021 to pre-COVID-19 levels was mainly driven by the growth of CA in secondary hospitals. Although there is a slight increase (2167) in CA in 2021 relative to 2019, both the absolute number and proportion of CA in the top 50 hospitals nationwide [53,887 (43.09%) vs. 63,811 (51.95%), < 0.001] and top three hospitals in each province [66,152 (52.73%) vs. 72,392 (59.28%), < 0.001] still declined significantly.

CONCLUSIONS

The CA experienced a substantial decline during the early phase of the COVID-19 pandemic, and then gradually returned to pre-COVID-19 levels. Notably, the growth of CA in secondary hospitals plays an important role in the overall resumption, which implies that systematic guidance of secondary hospitals with CA experience may aid in mitigating the negative impact of the COVID-19 pandemic.

摘要

背景

COVID-19 大流行显著影响了常规心血管健康评估和服务。我们旨在描述导管消融（CA）的时间趋势，并提供应对 COVID-19 大流行负面影响的经验。

方法

从国家心血管质量改进中心平台提取 2019 年 1 月至 2021 年 12 月期间的 CA 数据。使用广义估计方程评估 2019 年至 2021 年 CA 的变化。

结果

共纳入 347924 例接受 CA 的患者进行最终分析。CA 从 2019 年的 122839 例显著减少至 2020 年的 100019 例（-18.58%，95%CI：-33.40%至-3.75%， = 0.02），并在 2021 年略有增加至 125006 例（1.81%，95%CI：-7.01%至 3.38%， = 0.49）。2020 年 2 月 CA 经历了最大幅度的减少（-88.78%），与每月新 COVID-19 病例的峰值相对应，在 3 个月的封锁期间减少了 54.32%（95%CI：-71.27%至-37.37%， < 0.001），并于 2020 年 6 月首次相对于 2019 年增加。此后，2020 年的 CA 与 2019 年相比保持不变（-0.06%，95%CI：-7.01%至 3.38%， = 0.98）。值得注意的是，2021 年 CA 恢复到 COVID-19 前水平主要是由于二级医院 CA 的增长。尽管与 2019 年相比，2021 年 CA 略有增加（2167），但全国前 50 家医院[53887（43.09%）与 63811（51.95%）， < 0.001]和每个省前 3 家医院[66152（52.73%）与 72392（59.28%）， < 0.001]的 CA 绝对数量和比例仍明显下降。