Key result
Elective EP day-case rates vary widely, from ~80% for loop recorders to under 14% for CIEDs.
Why the study?
Electrophysiological procedures traditionally involving long hospital stays are increasingly performed as day cases, accelerated by the COVID-19 pandemic, prompting an exploration of current lengths of stay for elective procedures.
Cross-Sectional (n=245)
Yes
Despite advances and logistical pressures from the COVID-19 pandemic, the length of hospital stay for many elective EP procedures remains disproportionately long and widely variable.
Supports auditing local discharge practices to curb unnecessary CIED hospitalizations; leaves open optimal selection criteria for safe day-case procedures.
AIMS: 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. METHODS AND RESULTS: 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. CONCLUSION: 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.
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Boriani et al. (2023) conducted a cross-sectional in Elective electrophysiological procedures (n=245). Elective electrophysiological procedures was evaluated on Proportion of procedures undertaken as day cases vs overnight or longer hospital stays. There is a wide variation in length of hospital stay for elective EP procedures, with day case rates of 79.5% for loop recorders but less than 14% for de novo cardiac implantable electronic devices.
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