Department of Electrophysiology, Heart Center Leipzig at University Hospital, Strümpellstraße 39, 04289 Leipzig, Germany.
Leipzig Heart Institute, Leipzig, Germany.
Europace. 2021 Jan 27;23(1):149-156. doi: 10.1093/europace/euaa301.
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.
本项欧洲心脏病学会(EHRA)调查旨在评估电生理(EP)领域中当天出院(SDD)的应用情况。2020 年 6 月 12 日至 30 日,通过在线问卷调查的方式向 EHRA 社区成员收集信息,内容包括机构信息、并发症评估、近期经验以及对 SDD 可能具有的优势或顾虑的看法。共收到来自 49 个国家的 218 份回复,提供了当前 SDD 管理情况的信息。总体而言,SDD 的实施比例为 77.5%,而在三级和高容量中心这一比例明显更高(分别为 83.8%和 85.3%,均 P<0.01)。SDD 这一概念最常用于心脏事件记录器植入(97%)、诊断性 EP 程序(72.2%)和单/双心内导线起搏器植入(50%),而在左心房或室性心律失常的导管消融后 SDD 的应用比例最低。在实施 SDD 的中心中,约 90%的受访者表示这一出院概念是值得推荐或高度推荐的,并报告称再入院率和并发症发生率较低。大多数受访者认为可以更好地利用医院资源(78.2%)、提高成本效益(77.3%)和改善患者舒适度,但担心可能会影响对迟发性并发症的检测(72.5%)和管理(78.7%)。总之,超过 75%的受访者已经在 EP 介入治疗后实施 SDD,但具体程序的应用存在很大的异质性。需要进一步的研究来证实或证伪现有的和预期的益处及障碍。