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Background: As techniques for biventricular ICD implant (BiV ICD) improve, selective same day discharge (SSDD) is emerging as a safer and more cost-effective protocol than next day discharge (NDD).
Methods: This study was a retrospective chart review of 331 BiV ICD patients from a single site, with single operator, over a seven-year period (2008-2015). Criteria for inclusion in the study was successful implant of a de novo BiV ICD system. The study initially included 591 patients; 261 were excluded because of incomplete data or lack of de novo implant. Data collected includes date of birth, implant date, complications within two weeks, and healthcare utilizations within one month post-implant. Minor complications include infection, hematoma, lead dislodgement, elevated threshold or non-capture, over- or undersensing; major complications include pneumothorax, perforation, tamponade or death. Health care utilizations were defined as usage of the ER, OR, UC, an unanticipated office visit, or death.
Conclusions: The results suggest SSDD can be safe and highly cost effective for BiV ICD implants. Over 100,000 patients in the United States receive an ICD annually generating an expected patient savings of $5590 per patient. If SSDD were implemented nationally, expected savings would exceed half a billion dollars per year.
A limitation of this study is that the data draws from a single operator, however, these techniques and protocols can be adopted by other practices to produce the same results.
Poster Hall, Hall C
Friday, March 17, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Arrhythmias and Clinical EP: Devices 2
Abstract Category: 5. Arrhythmias and Clinical EP: Devices
Presentation Number: 1149-071
- 2017 American College of Cardiology Foundation