Utilization and perception of same-day discharge in electrophysiological procedures and device implantations: an EHRA survey

Abstract

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.

Safety of same-day discharge versus overnight stay strategy following cardiac device implantations: a high-volume single-centre experience

“…According to the results of a European Heart Rhythm Association (EHRA) survey published in 2014, elective device implantations were performed by the participating centres as day-case admissions in 30%, with a single overnight stay in 47%, with two-night admissions in 13%, and with more than two-night admissions in 10% [ 22 ]. However, a more recent EHRA survey published in 2021 demonstrated a significant shift in the clinical practice towards same-day discharge, since approximately 50% of respondents already implement this strategy at their institutions following implantations of pacemakers with one or two intracardiac leads [ 26 ]. Our study provides additional evidence towards this direction, showing that, currently, a change in clinical practice is reasonable and may be justified by procedural outcomes.…”

A Real-Time Complex Road AI Perception Based on 5G-V2X for Smart City Security

“…The Baidu map project team proposed a dual-view convolutional neutral network (DVCNN) for lane-line detection. The Korean Robotics and Computer Vision Laboratory proposed a method to extract multiple regions of interest, merging regions that may belong to the same class, and using a principal component analysis network (PCANet) and neural networks to classify candidate regions [25]. The laboratory proposed a vanishing point guided network (VPGNet) [26] to solve the problem of lane-line and pavement-marking recognition and classification under complex weather conditions.…”

SCAI expert consensus update on best practices in the cardiac catheterization laboratory

“…Selected patients after elective PCI should be considered for same‐day discharge after appropriate monitoring (usually 4–6 h) and the assessment of discharge readiness following the framework outlined in the SCAI and ACC consensus documents on length of stay and same day discharge following PCI 91–93 . Select EP procedures may also be considered for same day discharge 94–97 …”