Cardiac operations and interventions during the COVID-19 pandemic: a nationwide perspective

Francisco Leyva*, Abbasin Zegard, Osita Okafor, Berthold Stegemann, Peter Ludman, Tian Qiu

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review


AIMS : The COVID-19 pandemic has led to a decline in hospitalizations for non-COVID-19-related conditions. We explored the impact of the COVID-19 pandemic on cardiac operations and interventions undertaken in England.

METHODS AND RESULTS : An administrative database covering hospital activity for England, the Health Episodes Statistics, was used to assess a total of 286 697 hospitalizations for cardiac operations and interventions, as well as 227 257 hospitalizations for myocardial infarction (MI) and 453 799 for heart failure (HF) from 7 January 2019 to 26 July 2020. Over the 3 months of 'lockdown', total numbers and mean reductions in weekly rates [n (-%)], compared with the same time period in 2019, were: coronary artery bypass grafting [-2507 (-64%)]; percutaneous coronary intervention [-5245 (-28%)]; surgical [-1324 (-41%)] and transcatheter [-284 (-21%)] aortic valve replacement; mitral valve replacement; implantation of pacemakers [-6450 (-44%)], cardiac resynchronization therapy with [-356 (-42%)] or without [-491 (-46%)] defibrillation devices, and implantable cardioverter-defibrillators [-501 (-45%)]; atrial fibrillation ablation [-1902 (-83%)], and other ablations [-1712 (-64%)] (all P < 0.001). Over this period, there were 21 038 fewer procedures than in the reference period in 2019 (P < 0.001). These changes paralleled reductions in hospitalizations for MI [-10 794 (-27%)] and HF [-63 058 (-28%)] (both P < 0.001).

CONCLUSIONS : The COVID-19 pandemic has led to substantial reductions in the number of cardiac operations and interventions undertaken. An alternative strategy for healthcare delivery to patients with cardiac conditions during the COVID-19 pandemic is urgently needed.

Original languageEnglish
Pages (from-to)928-936
Number of pages9
Issue number6
Early online date29 Mar 2021
Publication statusPublished - 7 Jun 2021

Bibliographical note

© The Author(s) 2021. Published by Oxford University Press on behalf of the European Society of Cardiology
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (, which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact


  • Physiology (medical)
  • Cardiology and Cardiovascular Medicine
  • COVID-19
  • Heart failure
  • Myocardial infarction
  • Transcatheter aortic valve implantation
  • Pacemaker
  • Cardiac ablation
  • Aortic valve replacement
  • Cardiac resynchronization therapy
  • Implantable cardioverter-defibrillator
  • Mitral valve replacement


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