Utilization and perception of same-day discharge in electrophysiological procedures and device implantations: an EHRA survey

Author:

König Sebastian12,Svetlosak Martin3ORCID,Grabowski Marcin4,Duncker David5ORCID,Nagy Vivien K6,Bogdan Stefan7,Vanduynhoven Philippe8,Sohaib Syed Mohammad Afzal9,Malaczynska-Raipold Katarzyna10,Lane Deirdre A11,Lenarczyk Radoslaw12ORCID,Bollmann Andreas12,Hindricks Gerhard12,Potpara Tatjana S1314,Kosiuk Jedrzej415

Affiliation:

1. Department of Electrophysiology, Heart Center Leipzig at University Hospital, Strümpellstraße 39, 04289 Leipzig, Germany

2. Leipzig Heart Institute, Leipzig, Germany

3. Department for Arrhythmias and Cardiostimulation, National Institute for Cardiovascular Diseases, Bratislava, Slovakia

4. Department of Cardiology, Medical University of Warsaw, Warsaw, Poland

5. Department of Cardiology and Angiology, Hannover Medical School, Hannover Heart Rhythm Center, Hannover, Germany

6. Semmelweis University Heart and Vascular Center, Budapest, Hungary

7. Clinical Emergency Hospital of Bucharest, Clinical Electrophysiology and Pacing Laboratory, Bucharest, Romania

8. Department of Cardiology, Arrhythmia Clinic Aalst, Aalst, Belgium

9. Barts Heart Center, St Bartholomew's Hospital, London, UK

10. Royal Brompton & Harefield NHS Foundation Trust, Heart Division, London, UK

11. University of Liverpool and Liverpool Heart and Chest Hospital, Liverpool Centre for Cardiovascular Science, Liverpool, UK

12. Department of Cardiology Congenital Heart Disease and Electrotherapy, Silesian Medical University, Zabrze, Poland

13. School of Medicine, University of Belgrade, Belgrade, Serbia

14. Clinical Centre of Serbia, Cardiology Clinic, Belgrade, Serbia

15. Department of Cardiology, Helios Hospital Köthen, Köthen, Germany

Abstract

Abstract The aim of this European Heart Rhythm Association (EHRA) survey was to assess the utilization of same-day discharge (SDD) in electrophysiology (EP). An online-based questionnaire was shared with the EHRA community between 12 and 30 June 2020 and recorded institutional information, complication assessment, recent experiences, and opinions regarding possible advantages or concerns with SDD. In total, 218 responses from 49 countries provided information on current SDD management. Overall, SDD was implemented in 77.5%, whereas this proportion was significantly higher in tertiary and high-volume centres (83.8% and 85.3%, both P < 0.01). The concept of SDD was most commonly used following implantations of cardiac event recorders (97%), diagnostic EP procedures (72.2%), and implantations of pacemakers with one or two intracardiac leads (50%), while the lowest SDD utilization was observed after catheter ablations of left atrial or ventricular arrhythmias. Within SDD-experienced centres, ∼90% respondents stated that this discharge concept is recommendable or highly recommendable and reported that rates of increased rehospitalization and complication rates were low. Most respondents assumed a better utilization of hospital resources (78.2%), better cost effectiveness (77.3%), and an improved patients’ comfort but were concerned about possible impairment of detection (72.5%) and management (78.7%) of late complications. In conclusion, >75% of respondents already implement SDD following EP interventions with a large heterogeneity with regard to specific procedures. Further research is needed to confirm or disprove existing and expected benefits and obstacles.

Publisher

Oxford University Press (OUP)

Subject

Physiology (medical),Cardiology and Cardiovascular Medicine

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