Table 3.

Categorization of electrophysiological procedures in the context of COVID-19

	Urgent (perform within days)	Lower priority (perform within <3 months)	Elective (may be postponed ≥3 months)	Personal protection level
Catheter ablation	VT/VF ablation for electrical storm AF or A flutter ablation for AF/A flutter causing tachycardiomyopathy or syncope WPW syndrome with fast preexcited AF and or syncope and/or cardiac arrest	VT ablation for medically refractory recurrent VT AF/A flutter ablation for medically refractory AF/A flutter with repeated ER visits Medically refractory SVT with repeated ER visits	PVC ablation PSVT ablation AF/A flutter ablation EP testing	II/III
Cardiac implantable electronic device	Urgent PM implantation for symptomatic high-degree AV block or sinus node dysfunction with long asystolic pauses Urgent secondary prevention ICD implantation for cardiac arrest or VT ICD/PM battery replacement for imminent or actual EOL in PM-dependent patients Lead revision for symptomatic malfunction Lead extraction for infection	ICD/PM battery replacement for ERI Primary prevention ICD in very high-risk or life-threatening ventricular arrhythmias	Primary prevention ICD CRT implantation CIED upgrade Lead extraction in patient without infection Lead revision for asymptomatic malfunction	II/III
Cardioversion/other EP procedures	Highly symptomatic medically refractory new onset of AF/A flutter	Symptomatic medically refractory AF/A flutter	LAA closure ILR implantation Tilt table testing Ambulatory rhythm monitoring	II/III

A, atrial; AF, atrial fibrillation; AV, atrioventricular; CIED, cardiac implantable electronic device; CRT, cardiac resynchronization therapy; EOL, end of life; EP, electrophysiology; ER, emergency room; ERI, elective replacement indicator; ICD, implantable cardioverter–defibrillator; ILR, implantable loop recorder; LAA, left atrial appendage; PM, pacemaker; PSVT, paroxysmal supraventricular tachycardia; PVC, premature ventricular contraction; SVT, supraventricular tachycardia; VF, ventricular fibrillation; VT, ventricular tachycardia; WPW, Wolff–Parkinson–White syndrome.