A hub-and-spoke model: the role of satellite cardiac electrophysiology laboratory units in mitigating the waiting list pressures for catheter ablation for atrial fibrillation

Abstract Funding Acknowledgements Type of funding sources: None. Background Since setting up the cardiac electrophysiology (EP) service at our tertiary centre (UH) in 2010, there has been a significant increase referrals for EP procedures especially catheter ablation atrial fibrillation (AF). UH serves catchment area above 1 million people and increasing demand coupled with limited resources publicly funded health system led to huge supply-demand mismatch AF waiting list. This was compounded by COVID-19 pandemic. Aim To share experience how we attempted mitigate list pressures on before during pandemic utilising satellite laboratory units. Methods Firstly, made cryoballoon pulmonary vein isolation (PVI) initial strategy all paroxysmal persistent patients undergoing (due shorter procedure times standardised workflow). All PVI cases were performed under local anaesthesia. In 2016, transitioned from overnight-stay same-day demonstrated its safety cost-effectiveness. Finally, increased capacity developing hub-and-spoke model collaboration 2 secondary care centres regionally (WH & StX). From May 2019, 3 sites: (hub) units During pandemic, national lockdowns declared (23/3/20, 5/11/20, 6/1/21) healthcare services restructured. Urgent inpatient still but elective across three sites (UH, WH StX) cancelled first lockdown. One steps taken impact collaborate private sector (MH) which functioned as ‘clean’ site procedures. Cryoballoon resumed within months September 2020, [UH two MH)] performing PVI. Data every case entered into an electronic database. extracted 1st January 2019 (pre-pandemic) 31st December 2021 (post-pandemic). labeled ‘tertiary unit’ while WH, StX MH pooled together ‘satellite units’. Results The implementation transient decrease number (Figure 1). However, patient pathway that rapidly established unit facilitated sustained delivery throughout 2020 2021. There no deaths or differences complication rates between (Table Conclusion Our is safe practical tackling even