Same-day Discharge after Subcutaneous Implantable Cardioverter-defibrillator Implantation is Safe and Cost-effective

Swinning, Jill; Fox, Kelli; Billakanty, Sreedhar R.; Brown, Shannon V; Chopra, Nagesh; Fu, Eugene Y.; James, Justin; Kidwell, Gregory A.; Kleman, James M.; Murnane, Victoria; Nelson, Sarah E.; Nichols, Allan J.; Nichols, Suzean; Robinson, Andrea; Amin, Anish K.

doi:10.19102/icrm.2020.110602

Cited by 4 publications

(6 citation statements)

References 4 publications

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“…There is growing data supporting the safety, feasibility, and cost-effectiveness of this approach after CIED implants (transvenous pacemaker/ICD/CRT, sub-cutaneous ICDs, and Micra® leadless pacemaker). 2 , 4 , 13 Similarly, patients undergoing electrophysiological studies and ablation for SVT or right-sided atrial flutter/tachycardia have been safely discharged home on the same day for years. 14 More recently there is mounting evidence on the safety and cost-effectiveness of SDD in patients undergoing ablation for atrial fibrillation.…”

Section: Discussionmentioning

confidence: 99%

“… 1 Over the past decade, there has been a shift to same-day discharge (SDD) for a variety of electrophysiology procedures. 2–4 The COVID-19 pandemic has increased the need to limit the time patients spend in the hospital. The American College of Cardiology (ACC) has issued an expert decision pathway for SDD after percutaneous coronary intervention (PCI).…”

Section: Introductionmentioning

confidence: 99%

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Same-day discharge after transvenous lead extraction: feasibility and outcomes

et al. 2022

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Aims Same-day discharge (SDD) is safe for patients undergoing electrophysiology procedures. There is no existing data regarding SDD for patients undergoing transvenous lead extraction (TLE). We report our experience with SDD for patients undergoing TLE. Methods and results The study group included patients undergoing TLE between February 2020 and July 2021 without an infectious indication. A modified SDD protocol for device implants/ablations was applied to TLE patients. Patient characteristics, extraction details, outcomes, and complications were reviewed. Of 239 patients undergoing TLE, 210 were excluded (94 infections and 116 did not meet SDD criteria). Of the remaining 29 patients, seven stayed due to patient preference and 22 were discharged home the same day. The SDD group had an average age of 65.9 ± 12 (47–84), 41% female, and LVEF of 52.2 ± 18% (10–80). The indication for TLE was malfunction (20), upgrade (4), advisory lead (2), and magnetic resonance imaging compatibility (1). Extractions included four implantable cardioverter-defibrillators (ICDs), 17 pacemakers (PPM), and one cardiac resynchronization therapy (CRT)-P system. The leads were 9.6 years (1.5–21.7) old, and 1.8 leads were removed per patient (1–3); the lead extraction difficulty (LED) score was 11.6 ± 7. Twenty underwent cardiovascular implantable electronic device (CIED) re-implantation (2 ICD, 3 CRT-D, 13 PPM, and 2 CRT-P). For CIED re-implants, patients sent a remote transmission the next day, and all patients received a next-day call. There were no procedure or device-related issues, morbidities, or mortalities in the 30 days after discharge. Conclusion Same-day discharge after TLE for non-infectious aetiologies is safe and feasible in a select group of patients with early procedure completion who meet strict SDD criteria.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Same-day discharge after transvenous lead extraction: feasibility and outcomes

et al. 2022

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“…Outcomes regarding readmission were available in four studies. 18,20,22,23 Pooled readmission rates were 17.6%, and 17.5% in SDD and HO groups respectively. There were no statistically significant differences in readmission between SDD and HO groups (pooled OR = 0.95, 95%CI: 0.74-1.21, p = .667, I 2 = 49.3%).…”

Section: Readmissionmentioning

confidence: 96%

“…A total of eight studies from 2012 to June 2020 were included in this meta-analysis. [16][17][18][19][20][21][22][23] There were 1 RCT, three prospective cohort studies, and four retrospective cohort studies. The final analysis included a total of 61,602 patients (4,153 in SDD group and 57,449 in HO group) with a follow-up time range from 0.5 to 16 months.…”

Section: Description Of Included Studiesmentioning

confidence: 99%

Same‐day discharge after implantation of cardiac implantable electronic devices: A systematic review and meta‐analysis

Trongtorsak

Kewcharoen

Thangjui

et al. 2021

Pacing Clinical Electrophis

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Background: Due to an increasing need for cardiac implantable electronic device (CIED) placement, the cost of healthcare has been rising including the cost of hospital stay after the procedure. We conducted this systematic review and meta-analysis to assess the safety and feasibility of same-day discharge (SDD) after cardiac device implantations. Methods:We searched MEDLINE, and Embase databases from inception to March 2021 to identify studies that compared clinical outcomes between SDD group and hospital overnight stay (HO) group after cardiac device implantations. Outcomes included complications after the procedure, mortality, and re-hospitalization. Data from each study were combined using the random-effects model to calculate pooled odds ratio (OR) with 95% confidence interval (CI).Results: Eight studies (one randomized control trial, three prospective cohort and four retrospective cohort studies) with a total of 61,602 patients (4153 in SDD group and 57,449 in HO group) were included. SDD was not associated with more procedure-related complications. The rates of wound problems (0.94% vs 1.84%, pooled OR = 0.86, 95%CI: 0.2-3.68, p = .834), pneumothorax (1.15% vs 0.73%, pooled

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“…Management, the results of a small series of patients at Riverside Hospital in Columbus, Ohio are reported. Among patients (n = 24) who underwent S-ICD, half of whom were sent home on the same day as device implantation (n = 13), Swinning et al, 3 found no specific increased risk. A reasonable health care system cost savings of $1,664.48 per patient was reaped with the protocol of same-day early discharge after S-ICD implantation.…”

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

confidence: 98%

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

Ellis

2020

J Innov Cardiac Rhythm Manage.

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Same-day Discharge after Subcutaneous Implantable Cardioverter-defibrillator Implantation is Safe and Cost-effective

Cited by 4 publications

References 4 publications

Same-day discharge after transvenous lead extraction: feasibility and outcomes

Same-day discharge after transvenous lead extraction: feasibility and outcomes

Same‐day discharge after implantation of cardiac implantable electronic devices: A systematic review and meta‐analysis

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

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