Abstract 532 Updated survey on Interventional Electrophysiology in Germany during the COVID-19 pandemic: 10-year follow-up of infrastructure, procedures, and training positions

Introduction: This study provides an update of nationwide survey-based data providing an overview of the current status and development of EP patient care and physician training over the last decade assessing overall infrastructure, types, and numbers of procedures and training opportunities in Germany.

Methods: By analyzing mandatory quality reports German cardiology centres performing electrophysiological studies were identified and contacted to repeat a questionnaire from 2010 and 2015.

Results: A complete questionnaire was filled out by 192 German cardiology centers (56%) accounting for 76304 electrophysiologic procedures with 68,407 ablations; this represents about 78% of all catheter ablations in Germany in 2020. EP (ablation procedures and electrical device therapy) was mainly part of a cardiology department (89%) and independent (with its own budget) in 11%. Illustrating the rise of catheter ablations, the median number of ablations increased from 180 in 2010 to 377 in 2020. Comparing 2010 (2015) with 2020, the total number of ablations increased by 104% and 38%, respectively. Atrial fibrillation (AF) was the most common arrhythmia ablated (51% vs 35% in 2010). Pulmonary vein isolation (PVI) with radiofrequency point-by-point ablation (64%) and cryo balloon ablation (34%) were the preferred ablation strategies. 31% (36%) of all centres performed less than 50 (75) PVI in 2020. 6% of centres reported performing stand-alone surgical AF ablation. The proportion of VT ablations remained relatively stable (11% vs 8% in 2010). Only 25% and 55% of participating centres fulfilled all EHRA and DGK accreditation requirements, respectively. Compared to the previous surveys there was still a high number of EP centres with no EP fellows (38%). The proportions of female physicians in EP training increased from 26% in 2010 to 33% in 2020, in parallel the proportion of female EP consultants (“Oberärztin”) increased from 14% to 24% with a still very low number of female heads of EP department (4%).

Conclusion: Comparing 2020 with 2010 and 2015, an increasing number of EP centres and procedures in Germany are registered. In 2020, more than every second ablation was for therapy of AF. In the presence of an increasing number of procedures training opportunities are still limited, and most centres do not fulfill recommended EHRA or DGK requirements for training centre accreditation.

Clin Res Cardiol (2022). https://doi.org/10.1007/s00392-022-02002-5
Updated survey on Interventional Electrophysiology in Germany during the COVID-19 pandemic: 10-year follow-up of infrastructure, procedures, and training positions
F. Doldi¹, P. Sommer², S. Busch³, D. Duncker⁴, H. L. Estner⁵, M. Kuniss⁶, A. Metzner⁷, C. Meyer⁸, H.-R. Neuberger⁹, S. Rolf¹⁰, D. Steven¹¹, R. R. Tilz¹², F. Voss¹³, L. Eckardt¹
¹Klinik für Kardiologie II - Rhythmologie, Universitätsklinikum Münster, Münster; ²Klinik für Elektrophysiologie/Rhythmologie, Herz- und Diabeteszentrum NRW, Bad Oeynhausen; ³II. Medizinische Klinik - Kardiologie, Angiologie, Pneumologie, REGIOMED-KLINIKEN GmbH, Coburg; ⁴Kardiologie und Angiologie, Medizinische Hochschule Hannover, Hannover; ⁵Med. Klinik u. Poliklinik, Interventionelle Elektrophysiologie, LMU Klinikum der Universität München, München; ⁶Abteilung für Kardiologie, Kerckhoff Klinik GmbH, Bad Nauheim; ⁷Klinik für Kardiologie mit Schwerpunkt Elektrophysiologie, Universitäres Herz- und Gefäßzentrum Hamburg GmbH, Hamburg; ⁸Klinik für Kardiologie, Evangelisches Krankenhaus Düsseldorf, Düsseldorf; ⁹Elektrophysiologie / Rhythmologie, Klinikum Traunstein, Traunstein; ¹⁰Klinik für Innere Medizin Schwerpunkt Kardiologie, DRK-Kliniken Berlin Westend, Berlin; ¹¹Elektrophysiologie, Herzzentrum der Universität zu Köln, Köln; ¹²Medizinische Klinik II / Kardiologie, Angiologie, Intensivmedizin, Universitätsklinikum Schleswig-Holstein, Lübeck; ¹³Rhythmologie, Krankenhaus der Barmherzigen Brüder Trier, Trier;
Introduction: This study provides an update of nationwide survey-based data providing an overview of the current status and development of EP patient care and physician training over the last decade assessing overall infrastructure, types, and numbers of procedures and training opportunities in Germany. Methods: By analyzing mandatory quality reports German cardiology centres performing electrophysiological studies were identified and contacted to repeat a questionnaire from 2010 and 2015. Results: A complete questionnaire was filled out by 192 German cardiology centers (56%) accounting for 76304 electrophysiologic procedures with 68,407 ablations; this represents about 78% of all catheter ablations in Germany in 2020. EP (ablation procedures and electrical device therapy) was mainly part of a cardiology department (89%) and independent (with its own budget) in 11%. Illustrating the rise of catheter ablations, the median number of ablations increased from 180 in 2010 to 377 in 2020. Comparing 2010 (2015) with 2020, the total number of ablations increased by 104% and 38%, respectively. Atrial fibrillation (AF) was the most common arrhythmia ablated (51% vs 35% in 2010). Pulmonary vein isolation (PVI) with radiofrequency point-by-point ablation (64%) and cryo balloon ablation (34%) were the preferred ablation strategies. 31% (36%) of all centres performed less than 50 (75) PVI in 2020. 6% of centres reported performing stand-alone surgical AF ablation. The proportion of VT ablations remained relatively stable (11% vs 8% in 2010). Only 25% and 55% of participating centres fulfilled all EHRA and DGK accreditation requirements, respectively. Compared to the previous surveys there was still a high number of EP centres with no EP fellows (38%). The proportions of female physicians in EP training increased from 26% in 2010 to 33% in 2020, in parallel the proportion of female EP consultants (“Oberärztin”) increased from 14% to 24% with a still very low number of female heads of EP department (4%). Conclusion: Comparing 2020 with 2010 and 2015, an increasing number of EP centres and procedures in Germany are registered. In 2020, more than every second ablation was for therapy of AF. In the presence of an increasing number of procedures training opportunities are still limited, and most centres do not fulfill recommended EHRA or DGK requirements for training centre accreditation.
https://dgk.org/kongress_programme/jt2022/aP1515.html