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Day‐case device implantation—A prospective single‐center experience including patient satisfaction data
Author(s) -
Peplow Jessica,
Randall Esther,
CampbellCole Carolyn,
Kamdar Ravi,
Petzer Ed,
Dhillon Para,
Murgatroyd Francis,
Scott Paul A.
Publication year - 2018
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/pace.13324
Subject(s) - medicine , single center , prospective cohort study , patient satisfaction , implantable cardioverter defibrillator , cardiac resynchronization therapy , heart rhythm , surgery , heart failure , ejection fraction
Purpose Many centers perform day‐case cardiac rhythm management (CRM) device implantation. However, there is a paucity of prospective data concerning this approach. We performed a prospective single‐center study of day‐case device implantation, including data on patient satisfaction. Methods All patients scheduled for a new elective device were considered for a day‐case procedure. Exclusion criteria were living alone or without a suitable carer, advancing age/frailty, a metallic valve, and persistent complete heart block. Following discharge, patients were reviewed in device clinic at 6 weeks with an anonymized questionnaire. Results During the study period (May 2014–August 2016), 797 new CRM devices were implanted. Of these, 232 were elective and included in the analysis; 101 were planned to be day‐case and 131 scheduled for overnight stay. Of the 101 day‐case patients, 52 had a pacemaker, 28 an implantable cardioverter defibrillator (ICD), 16 a cardiac resynchronization therapy pacemaker/defibrillator, and five a subcutaneous‐ICD. Complications were similar in the day‐case (n = 12, 12%) and overnight stay (n = 15, 11%) groups (P = 0.92). In the day‐case group, 93 (92%) patients went home the same day. An estimated 111 overnight bed days were saved, translating to a cost saving of £61,912 (euro 70,767, $79,211). Note that 99% (n = 100) of patients returned the questionnaire. Patient satisfaction was universally high. The majority (n = 98, 98%) felt ready to go home on discharge; only a minority (n = 5, 5%) would have preferred an overnight stay. Conclusions A significant proportion of elective new CRM device implants can be performed as day‐case procedures. With appropriate selection patient acceptability of same‐day discharge is high.