Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, Via del Pozzo, 71, Modena 41124, Italy.
mHealth and Health Economics and PROM Committee of EHRA (European Heart Rhythm Association).
Europace. 2023 Oct 5;25(10). doi: 10.1093/europace/euad297.
Electrophysiological (EP) operations that have traditionally involved long hospital lengths of stay (LOS) are now being undertaken as day case procedures. The coronavirus disease-19 pandemic served as an impetus for many centres to shorten LOS for EP procedures. This survey explores LOS for elective EP procedures in the modern era.
An online survey consisting of 27 multiple-choice questions was completed by 245 respondents from 35 countries. With respect to de novo cardiac implantable electronic device (CIED) implantations, day case procedures were reported for 79.5% of implantable loop recorders, 13.3% of pacemakers (PMs), 10.4% of implantable cardioverter defibrillators (ICDs), and 10.2% of cardiac resynchronization therapy (CRT) devices. With respect to CIED generator replacements, day case procedures were reported for 61.7% of PMs, 49.2% of ICDs, and 48.2% of CRT devices. With regard to ablations, day case procedures were reported for 5.7% of atrial fibrillation (AF) ablations, 10.7% of left-sided ablations, and 17.5% of right-sided ablations. A LOS ≥ 2 days for CIED implantation was reported for 47.7% of PM, 54.5% of ICDs, and 56.9% of CRT devices and for 54.5% of AF ablations, 42.2% of right-sided ablations, and 46.1% of left-sided ablations. Reimbursement (43-56%) and bed availability (20-47%) were reported to have no consistent impact on the organization of elective procedures.
There is a wide variation in the LOS for elective EP procedures. The LOS for some procedures appears disproportionate to their complexity. Neither reimbursement nor bed availability consistently influenced LOS.
传统上需要长时间住院的电生理 (EP) 手术现在已作为日间手术进行。新冠疫情促使许多中心缩短 EP 手术的住院时间。本调查研究了现代 EP 择期手术的住院时间。
一项由 27 个多项选择题组成的在线调查由来自 35 个国家的 245 名受访者完成。对于新植入的心脏植入式电子设备 (CIED)，报告称植入式环路记录器的日间手术占 79.5%，起搏器 (PM) 占 13.3%，植入式心律转复除颤器 (ICD) 占 10.4%，心脏再同步治疗 (CRT) 设备占 10.2%。对于 CIED 发生器更换，报告称 PM 占 61.7%，ICD 占 49.2%，CRT 设备占 48.2%。在消融术中，报告称心房颤动 (AF) 消融术占 5.7%，左侧消融术占 10.7%，右侧消融术占 17.5%。CIED 植入的住院时间≥2 天，PM 占 47.7%，ICD 占 54.5%，CRT 设备占 56.9%，AF 消融术占 54.5%，右侧消融术占 42.2%，左侧消融术占 46.1%。报告称，报销（43-56%）和床位可用性（20-47%）对择期手术的组织没有一致的影响。
择期 EP 手术的住院时间差异很大。某些手术的住院时间与其复杂性不成比例。报销和床位可用性都没有一致影响住院时间。
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