Safety and Cost-Effectiveness of Same-Day Cardiac Resynchronization Therapy and Implantable Cardioverter Defibrillator Implantation

Atherton, Gavin; McAloon, Christopher; Chohan, Bhaveek C.; Heining, Dominic; Anderson, Ben; Barker, Jethro; Randeva, Harpal S.; Osman, Faizel

doi:10.1016/j.amjcard.2016.02.019

Cited by 9 publications

(7 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The concept of day-case CIED implantations was first proposed over 30 years ago [12,13]; however, evidence regarding the safety of this strategy is still limited. Previous studies demonstrated that early ambulation and short-term observation after CIED implantation is safe and does not result in an increased complication rate [14][15][16][17][18][19][20][21]. Although these data originating from large-scale registries and nonrandomised studies suggest that most patients can be discharged safely within 24 h of successful CIED implantation [15,[17][18][19], evidence from large-scale, randomised controlled studies is limited.…”

Section: Discussionmentioning

confidence: 99%

“…On the other hand, a number of previous studies, most of which were non-randomised, demonstrated that early mobilisation and same-day discharge is safe, does not add to the complication rate, and reduces procedure-related costs [12][13][14][15][16][17][18][19][20][21].Two subsequent surveys in 2014 and 2021, organised by the European Heart Rhythm Association (EHRA), showed that implantations were performed as day-case admissions in 30% and 50%, respectively, indicating a wider acceptance of this strategy overtime; however, the optimal management protocol remains a matter of debate [22,23].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Safety of same-day discharge versus overnight stay strategy following cardiac device implantations: a high-volume single-centre experience

Archontakis

Oikonomou

Sideris

et al. 2022

J Interv Card Electrophysiol

View full text Add to dashboard Cite

Background The strategy of cardiac implantable electronic device (CIED) implantations performed as day-case admissions has gained a wider acceptance overtime; however, data on safety are still limited. This study aims to investigate the safety of a same-day discharge protocol introduced in our hospital for the postprocedural management of patients undergoing CIED implantation. Methods Α prospective, non-interventional, non-randomised study performed in a single high-volume implanting centre for a 16-month period (March 2020 to June 2021). At total of 821 of 965 (85.1%) patients scheduled for elective CIED implantation were considered to be eligible for inclusion in the Short-stay Device Management Protocol. These patients were compared with a historical group of 932 patients, meeting the same inclusion criteria. Results Procedure was successful in 812 patients (98.9%), committed to same-day discharge versus 921 of 932 patients (98.8%) admitted for overnight stay ( p = 0.87). Overall, 90-day complication rate was comparable in both groups (4.14% vs 4.07%, p = 0.95), as was major (1.46% vs. 1.82%, p = 0.55) and minor (2.67% vs. 2.25%, p = 0.64) complication rates. The composite early post-procedural complication rates and late post-procedural complication rates were comparable among groups (0.97 vs 1.18%, p = 0.70 and 0.73% vs 0.64%, p = 0.83, respectively). Six hundred sixty-seven patients (84%) preferred the same-day discharge strategy. Finally, a reduction of 792 bed-days was recorded, resulting in possible financial Health System benefits. Conclusions Same-day discharge is feasible and safe in the majority of patients referred for CIED implantation. Additionally, same-day discharge is preferred by patients and may reduce procedure-related costs due to significant bed-day reductions. Supplementary Information The online version contains supplementary material available at 10.1007/s10840-022-01319-5.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Safety of same-day discharge versus overnight stay strategy following cardiac device implantations: a high-volume single-centre experience

Archontakis

Oikonomou

Sideris

et al. 2022

J Interv Card Electrophysiol

View full text Add to dashboard Cite

show abstract

“…Both this study and the data we are now gathering from efforts to continue patient care during the ongoing COVID-19 pandemic support the potential for greater telemedicine adoption in medicine, potentially leading to an earlier diagnosis of problems and subsequent reductions in disease severity or complications. More specifically, in the area of cardiac electrophysiology, this study clearly marks another step toward alleviating hospital stay expenses and mobility limitations together with the other research available on same-day discharge after cardiac resynchronization therapy device implantation, 8 laser lead extraction (personal experience), atrial fibrillation ablation, 9 and left atrial appendage closure. 10…”

Section: In This Issue Of the Journal Of Innovations In Cardiac Rhythmmentioning

confidence: 82%

Same-day Subcutaneous Implantable Cardioverter-defibrillator Placement and Discharge: Another Step Toward Outpatient Electrophysiology

Ellis

2020

J Innov Cardiac Rhythm Manage.

View full text Add to dashboard Cite

“…All had New York Heart Failure Assessment (NYHA), 6 min walk test, transthoracic echocardiography, Minnesota Living with HF Questionnaire (MLHFQ), resting 12-lead ECG and blood sampling, including N-terminal probrain natriuretic peptide (NT-pro-BNP). All our elective implants were performed as same-day procedures as reported previously 11. All underwent echocardiography (Vivid 7, GE Healthcare, Horten, Norway) for left ventricular (LV) assessment by a nationally accredited operator on the same machine with measurements analysed offline.…”

Section: Methodsmentioning

confidence: 99%

Body composition in heart failure and the impact of cardiac resynchronisation therapy: a proof-of-concept study

et al. 2020

Self Cite

View full text Add to dashboard Cite

AimsBody composition (BC) is known to alter in heart failure. Cardiac resynchronisation therapy (CRT) improves left ventricular geometry but the impact on BC is unknown. Our aim was to evaluate BC in these patients before and after CRT implantation.MethodsProspective proof-of-concept pilot study of heart failure patients undergoing CRT between September 2014 and December 2015. Assessments performed pre-CRT and post-CRT (6 weeks and 6 months) were: BC parameters (using air-displacement plethysmography), New York Heart Failure classification for assessing symptom severity, echocardiography to assess left ventricular geometry, electrocardiography, Minnesota Heart Failure Questionnaire and N-terminal probrain natriuretic peptide (NT-pro-BNP). Repeated measures analysis of variance was performed to assess relative change over time and potential correlations.ResultsTwenty-five patients were recruited; mean-age (±SD) was 73.4±10.0 years, 23 males, 18 CRT defibrillators (remainder CRT pacemakers), 16 had ischaemic aetiology, 6 diabetics, 17 with left bundle-branch morphology on ECG and 10 had atrial fibrillation. Significant inverse correlations were observed in the first 6 weeks following CRT between fat mass and left ventricular end-diastolic volume (r=−0.69, p<0.01) and NT-pro-BNP and fat mass (r=0.41, p=0.05). No significant differences were noted over 6 months. There was an observed trend towards reduced fat mass in the first 6 weeks post-CRT implant driven by non-responders. There was no significant difference between responders and non-responders in BC over 6 months.ConclusionThis is the first study to observe interplay between BC and cardiac geometry/function following CRT; a trend in overall fat mass reduction was noted following CRT and merits further study.

show abstract

Safety and Cost-Effectiveness of Same-Day Cardiac Resynchronization Therapy and Implantable Cardioverter Defibrillator Implantation

Cited by 9 publications

References 24 publications

Safety of same-day discharge versus overnight stay strategy following cardiac device implantations: a high-volume single-centre experience

Safety of same-day discharge versus overnight stay strategy following cardiac device implantations: a high-volume single-centre experience

Same-day Subcutaneous Implantable Cardioverter-defibrillator Placement and Discharge: Another Step Toward Outpatient Electrophysiology

Body composition in heart failure and the impact of cardiac resynchronisation therapy: a proof-of-concept study

Contact Info

Product

Resources

About