Dear BHRS Members,
We are facing a very difficult time over the next few weeks and months to come. Although we as heart rhythm specialists may become directly involved in the care of COVID-19 patients, probably as big a challenge for us will be to keep our arrhythmia and device services running for those patients who absolutely need us. There are many unknowns and no absolute answers on how best to do this. Approaches will need to change and adapt to situations as they arise.
To help members and colleagues the BHRS will be working with our website managers to set up a forum or bulletin board on the BHRS website to share ideas and support colleagues before the end of week beginning 16/03/20.
Many of you will already be working locally towards making provisions for your services. A few ideas which may help and are supported by the BHRS include;
1) Moving all or most arrhythmia clinics to telephone or video consultations.
2) Using remote CIED monitoring as much as possible to reduce the need for patient visits. Changing scheduled in person evaluations to remote interrogations is recommended. Extending the time of in clinic follow ups to longer than ‘normal’ recommendations when safe to do so is also encouraged where remote monitoring is not available.
3) Having consultants triage the waiting lists to identify those cases that absolutely must get done (e.g. generator changes, secondary prevention ICDs etc.)
4) Setting up 24/7 pacing rotas to allow heart block patients to be permanently paced and discharged as soon as possible. This potentially could be shared across multiple hospitals in smaller centres.
Regardless of the approaches taken the BHRS would like to stress the importance of looking after yourselves. Please follow your individual trust policy regarding the use of personal protective equipment (PPE) when performing arrhythmia and/or device procedures on patients with suspected or diagnosed COVID-19.
Please follow government advice and keep up to date with changes to advice via the appropriate web links if you or your family develop symptoms (https://www.nhs.uk/conditions/coronavirus-covid-19/)
One of the wonderful things about being a heart rhythm specialist is that the community is extremely collegiate and supportive of each other. If any of you, our colleagues, need any advice or support please don’t hesitate to reach out to your colleagues locally, the BHRS council members or me personally and I am sure we will all do our best to help each other through this uncertain and worrying time.
President British Heart Rhythm Society