Key result
Higher center volume and onsite cardiac surgery are associated with differences in ablation spectrum, infrastructure, periprocedural safety precautions, and treatment of cardiac tamponade.
Why the study?
Although electrophysiological centers have institutional standards, evidence on the management of cardiac tamponade is lacking.
Cross-Sectional (n=189)
Yes
Center volume and onsite cardiac surgery availability impact the ablation spectrum, infrastructure, and management of cardiac tamponade in German EP centers.
Survey data show inconsistent tamponade protocols across centers; leaves open optimal strategies and need for prospective standardization studies.
BACKGROUND: Although electrophysiological (EP) centers have institutional standards, evidence on management of cardiac tamponade is lacking. AIM AND METHODS: A physician-based survey was conducted by sending out questionnaires to all hospitals in Germany performing EP procedures. To evaluate the infrastructure of EP centers and the impact of center volume and onsite cardiac surgery on the management of cardiac tamponade, the results of the survey were analyzed for low-volume (0-250 procedures per year), mid-volume (250-500 procedures), and high-volume (>500 procedures) centers, as well as for centers with and without onsite cardiac surgery. RESULTS: A total of 341 centers were identified and 189/341 (55%) returned data sets were analyzed. Most types of EP procedures are performed across all kinds of centers. Ablation of ventricular tachycardia (VT) is concentrated in higher volume centers and in centers with onsite cardiac surgery. None of the participating low-volume centers and only 13% of centers without onsite cardiac surgery responded to performing epicardial VT ablation. Irrespective of center volume and onsite cardiac surgery, neither body mass index nor age was reported to be an exclusion criterion for ablation procedures. Higher volume centers and centers with onsite cardiac surgery more often have dedicated EP laboratories and EP-nursing teams. Also, differences regarding periprocedural safety precautions and management of cardiac tamponade were found for low-, mid-, and high-volume centers, as well as for centers with and without onsite cardiac surgery. CONCLUSION: While center volume and onsite cardiac surgery do not impact patient selection, there are differences in ablation spectrum, infrastructure, periprocedural safety precautions, and treatment of tamponade.
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Rottner et al. (2023) conducted a cross-sectional in Electrophysiological procedures and cardiac tamponade management (n=189). Center volume and onsite cardiac surgery vs. Low-volume centers and centers without onsite cardiac surgery was evaluated on Infrastructure, periprocedural safety precautions, and management of cardiac tamponade. Higher center volume and onsite cardiac surgery are associated with differences in ablation spectrum, infrastructure, periprocedural safety precautions, and treatment of cardiac tamponade.
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