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Electrophysiology lab efficiency using cryoballoon for pulmonary vein isolation in central and eastern Europe: A sub-analysis of the cryo global registry study

C. Földesi, D. Kojić, A. Sudzinova, M. Kuniewicz, P. Neužil, Z. Csanadi, M. Škamla, M. Svetlošák, J. Romanek, R. Holbrook, M. Stefanic, A. Sale, TR. Holmes, P. Ptaszyński

. 2024 ; 31 (5) : 656-664. [pub] 20240813

Language English Country Poland

Document type Journal Article, Multicenter Study

Persistent link   https://www.medvik.cz/link/bmc25004199

BACKGROUND: Cryoballoon ablation for treatment of atrial fibrillation (AF) reduces procedure times, but limited data is available about its impact on electrophysiology (EP) lab efficiency in Central and Eastern Europe (CEE). Using CEE-specific procedure data, the present study modeled cryoballoon ablation procedures on EP lab resource consumption to improve efficiency. METHODS: A discrete event simulation model was developed to assess EP efficiency with cryoballoon ablation. Model inputs were taken from CEE sites within the Cryo Global Registry, namely Czech Republic, Hungary, Poland, Serbia, and Slovakia. The main endpoints were percentage of days that resulted in overtime and percentage of days with time for one extra simple EP procedure. Use of the 'figure of 8' (Fo8) closure technique to reduce procedure time was also examined. RESULTS: The mean lab occupancy time across all CEE sites was 133 ± 47 minutes (min: 104 minutes, max:181 minutes). Cryoballoon ablation in the base-case scenario resulted in 14.6% of days with overtime and 64.8% of days with time for an extra simple EP procedure. Use of the Fo8 closure technique enhanced these values to 5.5% and 85.3%, respectively. Model endpoints were most sensitive to changes in lab occupancy times and overtime start time. CONCLUSIONS: In this CEE-specific analysis of EP lab efficiency it was found that 3 cryoballoon ablation procedures could be performed in 1 lab day, leaving time for a 4th simple EP procedure on most days. As such, use cryoballoon ablation for PVI is an effective way to improve EP lab efficiency.

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$a Földesi, Csaba $u Gottsegen György Országos Kardiovaszkuláris Intézet, Budapest, Hungary
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$a BACKGROUND: Cryoballoon ablation for treatment of atrial fibrillation (AF) reduces procedure times, but limited data is available about its impact on electrophysiology (EP) lab efficiency in Central and Eastern Europe (CEE). Using CEE-specific procedure data, the present study modeled cryoballoon ablation procedures on EP lab resource consumption to improve efficiency. METHODS: A discrete event simulation model was developed to assess EP efficiency with cryoballoon ablation. Model inputs were taken from CEE sites within the Cryo Global Registry, namely Czech Republic, Hungary, Poland, Serbia, and Slovakia. The main endpoints were percentage of days that resulted in overtime and percentage of days with time for one extra simple EP procedure. Use of the 'figure of 8' (Fo8) closure technique to reduce procedure time was also examined. RESULTS: The mean lab occupancy time across all CEE sites was 133 ± 47 minutes (min: 104 minutes, max:181 minutes). Cryoballoon ablation in the base-case scenario resulted in 14.6% of days with overtime and 64.8% of days with time for an extra simple EP procedure. Use of the Fo8 closure technique enhanced these values to 5.5% and 85.3%, respectively. Model endpoints were most sensitive to changes in lab occupancy times and overtime start time. CONCLUSIONS: In this CEE-specific analysis of EP lab efficiency it was found that 3 cryoballoon ablation procedures could be performed in 1 lab day, leaving time for a 4th simple EP procedure on most days. As such, use cryoballoon ablation for PVI is an effective way to improve EP lab efficiency.
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$a Kojić, Dejan $u Institute for Cardiovascular Diseases Dedinje, Belgrade, Serbia
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$a Sudzinova, Adriana $u Východoslovenský ústav srdcovych a cievnych chorôb (VUSCH), Košice, Slovakia
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$a Kuniewicz, Marcin $u Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland
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$a Neužil, Petr $u Na Homolce Hospital, Prague, Czech Republic
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$a Csanadi, Zoltan $u Faculty of Medicine, University of Debrecen, Debrecen, Hungary
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$a Svetlošák, Martin $u Národný ústav srdcových a cievnych chorôb (NÚSCH) a Slovenská zdravotnícka univerzita (SZU), Bratislava, Slovakia
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$a Romanek, Janusz $u Clinical Provincial Hospital No. 2, Rzeszow, Poland
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$a Stefanic, Martin $u Medtronic, United States
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$a Ptaszyński, Paweł $u Medical University of Łódź, Central University Hospital, Łódź, Poland
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