Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2026
Improved patient value after implementing same day discharge for patients undergoing pulmonary vein isolation.
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Slingerland Stacey R, van de Kar Mileen R D, Vermeer Jasper, van Steenbergen Gijs J, Schulz Daniela N, van Veghel Dennis, Dekker Lukas
Аннотация
AIMS: Pulmonary vein isolation (PVI) is an effective intervention to treat atrial fibrillation, which is increasingly prevalent. Same-day discharge (SDD) is a strategic approach to limit procedure-related costs. This study aimed to compare healthcare utilization, costs, and clinical outcomes before and after implementation of an SDD protocol.
METHODS AND RESULTS: This retrospective study included 2987 patients undergoing PVI between 1 January 2016 and 1 April 2021. Baseline characteristics, pre-, peri-, and post-procedure healthcare utilization and clinical outcomes were compared before (cohort A; n = 1379) and after (Cohort B; n = 1608) implementation of the SDD protocol using bivariate and multivariate analyses. show that cohort B vs. cohort A had lower all-cause 90-day mortality (0% vs. 0.3%, P = 0.031), no differences in re-ablation < 1 year (P = 0.286), as well as in complications: bleedings (P = 0.177), tamponade < 30 days (P = 0.157), phrenic nerve injury (P = 0.984), thromboembolic complication < 72 h (P = 0.212), or vascular complications (P = 0.290). In terms of healthcare utilization and costs, cohort B had significantly less peri-procedure hospital admission costs (€721.52 vs. €1011.78, P < 0.001) and less total peri- and post-procedure costs (€840.37 vs. €1152.94, P < 0.001). Adjusted for all baseline characteristics, the post-implementation cohort showed on average €315 lower total costs per patient.
CONCLUSION: The implementation of the SDD protocol was associated with comparable complication rates while significantly reducing both peri- and post-procedure healthcare utilization and costs, thereby enhancing patient value. This indicates a potential margin for further cost reductions and increased efficiency.
METHODS AND RESULTS: This retrospective study included 2987 patients undergoing PVI between 1 January 2016 and 1 April 2021. Baseline characteristics, pre-, peri-, and post-procedure healthcare utilization and clinical outcomes were compared before (cohort A; n = 1379) and after (Cohort B; n = 1608) implementation of the SDD protocol using bivariate and multivariate analyses. show that cohort B vs. cohort A had lower all-cause 90-day mortality (0% vs. 0.3%, P = 0.031), no differences in re-ablation < 1 year (P = 0.286), as well as in complications: bleedings (P = 0.177), tamponade < 30 days (P = 0.157), phrenic nerve injury (P = 0.984), thromboembolic complication < 72 h (P = 0.212), or vascular complications (P = 0.290). In terms of healthcare utilization and costs, cohort B had significantly less peri-procedure hospital admission costs (€721.52 vs. €1011.78, P < 0.001) and less total peri- and post-procedure costs (€840.37 vs. €1152.94, P < 0.001). Adjusted for all baseline characteristics, the post-implementation cohort showed on average €315 lower total costs per patient.
CONCLUSION: The implementation of the SDD protocol was associated with comparable complication rates while significantly reducing both peri- and post-procedure healthcare utilization and costs, thereby enhancing patient value. This indicates a potential margin for further cost reductions and increased efficiency.