Urgent or elective ablation of AF
Catheter ablation for AF patients with active infection is generally contraindicated, which is similarly applied to COVID-19 patients.56Medical treatment to control ventricular rate or rhythm with adequate anticoagulation based on the risk score will be the preferred managment.56Electrical or chemical cardioversion is a reasonable alternative for refractory arrhythmias. COVID-19 fears put interventional laboratories on lockdown. The asymptomatic carriers or mildly symptomatic COVID-19 patients remain highly contagious and could be unexpectedly admitted. During active pandemic, the hospitalization of these patient would significantly increase the risk for group infection within hospitals. As most AF ablation is not an urgent procedure, these procedures are suggested to be postponed for several weeks or months during active pandemic to avoid unexpected outbreak in hospitals.57However, some electrophysiology (EP) procedures which are considered urgent or emergent for the diseases with substantially risk of clinical decompensation, hospitalization, or death might not be avoidable. These include AF, atrial flutter, or atrioventricular nodal ablation which is hemodynamically significant, severely symptomatic, drug and/or cardioversion refractory, or preexcited AF with syncope or cardiac arrest.57