BHRS: Living with COVID - Challenges and Benefits of Changes

Published: 14 May 2020

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Overview

Prof Francisco Leyva and Prof Mauro Biffi introduce this online video series, filmed in partnership with the BHRS. Through a series of 8 videos, they explain how faculty aim to draw parallels on hospital responses during the COVID-19 crisis and assess how treating patients in cardiology has been during this period and how cardiologists will continue to operate in what will be the new ‘normal’.

A Radcliffe Medical Media production in partnership with the British Heart Rhythm Society (BHRS).

More from this programme

Part 1

Introduction: Living with COVID

In this short video, chairs Prof Francisco Leyva and Prof Mauro Biffi introduce this online video series, filmed in partnership with the BHRS. Through a series of 8 videos, they explain how faculty aim to draw parallels on hospital responses during the COVID-19 crisis and assess how treating patients in cardiology has been during this period and how cardiologists will continue to operate in what will be the new ‘normal’.

Part 2

Continuing Cardiology: During and after COVID

Dr Howard Marshall meets with Prof Franciso Leyva and Prof Mauro Biffi and explores the issues affecting the Birmingham Hospitals NHS Trust, UK in light of the recent COVID pandemic and draws parallels with Italian experiences from Dr Mauro Biffi, Bologna, UK. Highlights include: - The impact on the hospitals within the Birmingham NHS Trust: hear how during the peak of surge, they had to transfer patients across hospitals as IC units became overwhelmed and how staff with ITU experience were upscaled to expand their ability to treat more patients, enabling them to treat up to 500 patients if needed. - The impact on delivering cardiology services: hear the effect COVID has had on the hospital's ability to manage and prioritise cardiology patients and procedures and how new triage methods and hospital pathways have been implemented in response. - How secondary prevention patients are being prioritized as well as the difficult decisions being taken to ensure the safety of primary prevention patients. - How COVID-19 is expediting the use of remote monitoring and diagnostic hubs to reduce hospital footfall as they discuss what might soon become be the new 'normal'.

Part 3

Remote Clinics & Investigations: What Have We Learnt During COVID?

Prof Hunter meets with Prof Leyva, to discuss the impact COVID-19 has had on cardiac outpatient departments and how clinical decisions and patient assessments are now being made by phone. Through a series of three real-life case studies, Prof Hunter highlights how patients can be managed remotely using a variety of digital technologies. Together they discuss the benefits and challenges of this innovative approach and at what cost.

Part 4

BNP and ECG as a Guide to Picking up Significant Valvular Heart Disease

Prof Bernard Prendergast (London, UK) meets with Chair, Prof Mauro Biffi, to discuss the management of valve disease in patients during the COVID-19 pandemic. He will look at how to diagnose VHD and identify what determines the need for clinical assessment. He will consider the risks for patients, as access to intervention and follow-up is limited, looking at ways to diagnose from a distance. He explains how physicians can identify which patients need to be seen and considers the various interventions to treat VHD, and the use of optimal medical therapy to 'hold' patients in the meantime.

Part 5

Imaging in the Era of COVID: Who Needs Imaging When Resources Are Limited??

Dr Sabharwal (Oxford, UK) presents how his hospital has had to change its approach to running an imaging lab, with a consideration of specific constraints due to COVID. He highlights: - How disease management processes have had to adapt and how patients are being prioritized and targetted for imaging to ensure patients can continue to be scanned despite the ongoing pandemic. - The importance of a good history and ECG for patient selection and consideration of which diseases are likely to need the closest follow-up, as well as a discussion around the risks of patients and staff from nuclear, CT/CMR, and echo.

Part 6

Running a Remote Device Clinic with Cases during and after COVID-19

Mr Matthew Swift (Great Western Hospitals NHS Foundation Trust, UK) meets with Chair, Prof Mauro Biffi to discuss the challenges and new aspects of managing device recipients post-COVID pandemic. Mr Swift discusses how remote follow up of device service is able to happen thanks to technology.

Part 7

Opportunities and Challenges with Remote Services during and after COVID-19

Mr Ian Wright (Imperial, London, UK) discusses the impact that COVID-19 has had on cardiac patients in his hospital. He presents an analysis of mortality rates as a result of COVID-19 complications and how this has resulted in double the expected deaths in ICD patients during the month of April 2020. He considers the requirements, challenges, and opportunities of remote monitoring, particularly with consideration for the elderly patient population.

Part 8

Patient Satisfaction With Remote Services During and After COVID-19

Trudie Lobban MBE, founder of the Arrhythmia Alliance Association joins Prof Leyva and Prof Mauro Biffi to discuss her experience of monitoring patients remotely and shares with the panel, feedback from her patients. Hear anecdotal reports of how patients have positively responded to remote management as well as a discussion of the benefits it brings for patients. With thanks to the Arrhythmia Alliance UK for their contribution to this video.

Part 9

Closing Remarks: Living with COVID

Chairs Prof F Leyva (Birmingham, UK) and Prof M Biffi (Bologna, IT) conclude this online video series by summarising the 7 presentations and discuss key learnings from the series, as well as drawing on the parallels and differences between the UK and Italian responses during COVID-19.

Faculty Biographies

Ian Wright

Ian Wright

Ian Wright is a principal cardiac physiologist at Imperial College Healthcare NHS Trust specialising in EP and device therapy. He has been involved in EP education for over a decade and has presented at HRC since its inception. He is a member of the BHRS council.

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