Key result
Early discharge with the Home Monitoring system after ambulatory CIED implantation was noninferior to standard management for treatment-related adverse events (11% vs 17%; ARR 6%, P=0.789).
Why the study?
Does early discharge with a Home Monitoring system reduce hospitalization duration and maintain safety in patients receiving primary CIEDs?
Cohort (n=364)
No
Does early discharge with a Home Monitoring system reduce hospitalization duration and maintain safety in patients receiving primary CIEDs?
Early discharge on the day of CIED implantation with home monitoring significantly reduces hospital stay without increasing treatment-related adverse events compared to standard hospitalization.
BACKGROUND: The Home Monitoring (HM) system of cardiac implantable electronic devices (CIEDs) permits early detection of arrhythmias or device system failures. The aim of this pilot study was to examine how the safety and efficacy of the HM system in patients after ambulatory implanted primary CIEDs compare to patients with a standard procedure and hospitalization. HYPOTHESIS: We hypothesized that HM and their modifications would be a useful extension of the present concepts for ambulatory implanted CIEDs. METHODS: This retrospective analysis evaluates telemetric data obtained from 364 patients in an ambulatory single center over 6 years. Patients were assigned to an active group (n = 217), consisting of those who were discharged early on the day of implantation of the primary CIED, or to a control group (n = 147), consisting of those discharged and followed up with the HM system according to usual medical practices. RESULTS: The mean duration of hospitalization was 73.2% shorter in the active group than in the control group, corresponding to 20.5 ± 13 fewer hours (95% confidence interval [CI]: 6.3-29.5; P < 0.01) spent in the hospital (7.5 ± 1.5 vs 28 ± 4.5 h). This shorter mean hospital stay was attributable to a 78.8% shorter postoperative period in the active group. The proportion of patients with treatment-related adverse events was 11% (n = 23) in the active group and 17% (n = 25) in the control group (95% CI: 5.5-8.3; P = 0.061). This 6% absolute risk reduction (95% CI: 3.3-9.1; P = 0.789) confirmed the noninferiority of the ambulatory implanted CIED when compared with standard management of these patients. CONCLUSIONS: Early discharge with the HM system after ambulatory CIED implantation was safe and not inferior to the classic medical procedure. Thus, together with lower costs, HM and its modifications would be a useful extension of the present concepts for ambulatory implanted CIEDs.
No takes yet. Share an insight, caveat, or question.
Parahuleva et al. (2017) conducted a cohort in Ambulatory implanted primary cardiac implantable electronic devices (CIEDs) (n=364). Early discharge with Home Monitoring (HM) system vs. Standard procedure and hospitalization was evaluated on treatment-related adverse events (ARR 6%, 95% CI 3.3-9.1, p=0.789). Early discharge with the Home Monitoring system after ambulatory CIED implantation was noninferior to standard management for treatment-related adverse events (11% vs 17%; ARR 6%, P=0.789).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: