A survey on patient preferences towards CIED implantation

Vamsidhar Naraparaju; Mansour Almnajam; Lisa Joseph; Gregory Vernon; Dorothy Wakefield; Anthony R Magnano; Aneesh Tolat

doi:10.1016/j.ipej.2021.04.004

A survey on patient preferences towards CIED implantation

Indian Pacing Electrophysiol J. 2021 Jul-Aug;21(4):227-231. doi: 10.1016/j.ipej.2021.04.004. Epub 2021 Apr 19.

Authors

Vamsidhar Naraparaju¹, Mansour Almnajam², Lisa Joseph³, Gregory Vernon⁴, Dorothy Wakefield⁵, Anthony R Magnano³, Aneesh Tolat⁴

Affiliations

¹ Division of Cardiology, Electrophysiology Section, Hoffman Heart and Vascular Institute, St. Francis Hospital and Medical Center, University of Connecticut School of Medicine, Hartford, 06105, CT, USA. Electronic address: naraparaju@uchc.edu.
² Division of Cardiology, University of Connecticut Health Center, Farmington, 06030, CT, USA.
³ Division of Cardiology, Saint Vincent's Medical Center, Ascension St. Vincent's, 1824 King St. Suite 250, Jacksonville, 32204, FL, USA.
⁴ Division of Cardiology, Electrophysiology Section, Hoffman Heart and Vascular Institute, St. Francis Hospital and Medical Center, University of Connecticut School of Medicine, Hartford, 06105, CT, USA.
⁵ Center on Aging, UConn Health, Farmington, 06030, CT, USA.

Abstract

Background: Cardiac implantable electronic device (CIED) implantation is increasingly performed worldwide with improving safety. Outpatient CIED implantation has similar complication rates compared to those implants which are hospitalized. Here, we analyze patient preferences on discharge timing after CIED implantation.

Objective: To identify and understand the factors contributing to patient preferences towards same-day or next-day discharge after CIED implantation.

Methods: One hundred and two patients undergoing new CIED implants were included in the study at two separate hospitals in CT (CT group) and FL (FL group) from 2018-2019. A 7-question survey was administered to the patients after the procedure. Survey responses and demographic data were statistically analyzed.

Results: Seventy-four percent of CT group and 58% of the FL group responded with a 10 score (0-10) that they were ready to be discharged home the same day (p=0.09). Both groups reported a low number of patients feeling safer by having a remote monitor provided at the time of discharge (44% CT group, 28% FL group; p=0.123). The mean distance of patients living from the hospital in CT group (21.6 miles) was significantly lower than that for the FL group (35.5 miles); p=0.01. Hypertension (86% vs 52%; p=0.0002) and Diabetes mellitus (44% vs 21%; p=0.013) were more prevalent in the FL group compared to the CT group.

Conclusion: Despite the influence of local practices, the majority of patients preferred same-day discharge after CIED implantation. Improved patient education regarding the ability of remote monitors to provide real-time response to acute events is needed.

Keywords: CIED implantation; Defibrillator; Outpatient; Pacemaker; Survey.