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使用冷冻球囊行肺静脉隔离术的电生理实验室效率：冷冻全球注册研究的亚分析。

Electrophysiology lab efficiency using cryoballoon for pulmonary vein isolation in central and eastern Europe: A sub-analysis of the cryo global registry study.

机构信息

Gottsegen György Országos Kardiovaszkuláris Intézet, Budapest, Hungary.

Institute for Cardiovascular Diseases Dedinje, Belgrade, Serbia.

出版信息

Cardiol J. 2024;31(5):656-664. doi: 10.5603/cj.98292. Epub 2024 Aug 13.

DOI:10.5603/cj.98292
PMID:39136617
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11544417/
Abstract

BACKGROUND

Cryoballoon ablation for treatment of atrial fibrillation (AF) reduces procedure times, but limited data is available about its impact on electrophysiology (EP) lab efficiency in Central and Eastern Europe (CEE). Using CEE-specific procedure data, the present study modeled cryoballoon ablation procedures on EP lab resource consumption to improve efficiency.

METHODS

A discrete event simulation model was developed to assess EP efficiency with cryoballoon ablation. Model inputs were taken from CEE sites within the Cryo Global Registry, namely Czech Republic, Hungary, Poland, Serbia, and Slovakia. The main endpoints were percentage of days that resulted in overtime and percentage of days with time for one extra simple EP procedure. Use of the 'figure of 8' (Fo8) closure technique to reduce procedure time was also examined.

RESULTS

The mean lab occupancy time across all CEE sites was 133 ± 47 minutes (min: 104 minutes, max:181 minutes). Cryoballoon ablation in the base-case scenario resulted in 14.6% of days with overtime and 64.8% of days with time for an extra simple EP procedure. Use of the Fo8 closure technique enhanced these values to 5.5% and 85.3%, respectively. Model endpoints were most sensitive to changes in lab occupancy times and overtime start time.

CONCLUSIONS

In this CEE-specific analysis of EP lab efficiency it was found that 3 cryoballoon ablation procedures could be performed in 1 lab day, leaving time for a 4th simple EP procedure on most days. As such, use cryoballoon ablation for PVI is an effective way to improve EP lab efficiency.

摘要

背景

冷冻球囊消融治疗心房颤动 (AF) 可缩短手术时间，但关于其对中欧和东欧 (CEE) 电生理 (EP) 实验室效率的影响，数据有限。本研究使用 CEE 特定的手术数据，通过模拟冷冻球囊消融手术对 EP 实验室资源消耗的影响来提高效率。

方法

开发了一个离散事件模拟模型来评估冷冻球囊消融术的 EP 效率。模型输入来自 Cryo Global Registry 中的 CEE 站点，即捷克共和国、匈牙利、波兰、塞尔维亚和斯洛伐克。主要终点是导致加班的天数百分比和每天有时间进行额外简单 EP 手术的天数百分比。还检查了使用“8 字形”（Fo8）闭合技术来缩短手术时间的情况。

结果

所有 CEE 站点的平均实验室占用时间为 133 ± 47 分钟（min：104 分钟，max：181 分钟）。在基础情况下进行冷冻球囊消融术导致 14.6%的天数加班，64.8%的天数有时间进行额外的简单 EP 手术。使用 Fo8 闭合技术可将这些值分别提高到 5.5%和 85.3%。模型终点对实验室占用时间和加班开始时间的变化最为敏感。

结论

在这项针对 CEE 特定的 EP 实验室效率分析中，发现 1 个实验室日可完成 3 个冷冻球囊消融手术，在大多数日子里还可留出时间进行第 4 个简单的 EP 手术。因此，使用冷冻球囊消融进行 PVI 是提高 EP 实验室效率的有效方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9560/11544417/3e5bf20cf905/cardj-31-5-656f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9560/11544417/93bb4f02626e/cardj-31-5-656f5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9560/11544417/caf24575ac2d/cardj-31-5-656f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9560/11544417/ec7cb6de1ec6/cardj-31-5-656f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9560/11544417/e6ef3f438f83/cardj-31-5-656f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9560/11544417/3e5bf20cf905/cardj-31-5-656f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9560/11544417/93bb4f02626e/cardj-31-5-656f5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9560/11544417/caf24575ac2d/cardj-31-5-656f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9560/11544417/ec7cb6de1ec6/cardj-31-5-656f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9560/11544417/e6ef3f438f83/cardj-31-5-656f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9560/11544417/3e5bf20cf905/cardj-31-5-656f4.jpg

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