The infrastructure of electrophysiology centers impacts the management of cardiac tamponade-Results from a national survey.


Journal

Clinical cardiology
ISSN: 1932-8737
Titre abrégé: Clin Cardiol
Pays: United States
ID NLM: 7903272

Informations de publication

Date de publication:
Oct 2023
Historique:
revised: 27 06 2023
received: 25 03 2023
accepted: 13 07 2023
medline: 23 10 2023
pubmed: 1 8 2023
entrez: 1 8 2023
Statut: ppublish

Résumé

Although electrophysiological (EP) centers have institutional standards, evidence on management of cardiac tamponade is lacking. A physician-based survey was conducted by sending out questionnaires to all hospitals in Germany performing EP procedures. To evaluate the infrastructure of EP centers and the impact of center volume and onsite cardiac surgery on the management of cardiac tamponade, the results of the survey were analyzed for low-volume (0-250 procedures per year), mid-volume (250-500 procedures), and high-volume (>500 procedures) centers, as well as for centers with and without onsite cardiac surgery. A total of 341 centers were identified and 189/341 (55%) returned data sets were analyzed. Most types of EP procedures are performed across all kinds of centers. Ablation of ventricular tachycardia (VT) is concentrated in higher volume centers and in centers with onsite cardiac surgery. None of the participating low-volume centers and only 13% of centers without onsite cardiac surgery responded to performing epicardial VT ablation. Irrespective of center volume and onsite cardiac surgery, neither body mass index nor age was reported to be an exclusion criterion for ablation procedures. Higher volume centers and centers with onsite cardiac surgery more often have dedicated EP laboratories and EP-nursing teams. Also, differences regarding periprocedural safety precautions and management of cardiac tamponade were found for low-, mid-, and high-volume centers, as well as for centers with and without onsite cardiac surgery. While center volume and onsite cardiac surgery do not impact patient selection, there are differences in ablation spectrum, infrastructure, periprocedural safety precautions, and treatment of tamponade.

Sections du résumé

BACKGROUND BACKGROUND
Although electrophysiological (EP) centers have institutional standards, evidence on management of cardiac tamponade is lacking.
AIM AND METHODS OBJECTIVE
A physician-based survey was conducted by sending out questionnaires to all hospitals in Germany performing EP procedures. To evaluate the infrastructure of EP centers and the impact of center volume and onsite cardiac surgery on the management of cardiac tamponade, the results of the survey were analyzed for low-volume (0-250 procedures per year), mid-volume (250-500 procedures), and high-volume (>500 procedures) centers, as well as for centers with and without onsite cardiac surgery.
RESULTS RESULTS
A total of 341 centers were identified and 189/341 (55%) returned data sets were analyzed. Most types of EP procedures are performed across all kinds of centers. Ablation of ventricular tachycardia (VT) is concentrated in higher volume centers and in centers with onsite cardiac surgery. None of the participating low-volume centers and only 13% of centers without onsite cardiac surgery responded to performing epicardial VT ablation. Irrespective of center volume and onsite cardiac surgery, neither body mass index nor age was reported to be an exclusion criterion for ablation procedures. Higher volume centers and centers with onsite cardiac surgery more often have dedicated EP laboratories and EP-nursing teams. Also, differences regarding periprocedural safety precautions and management of cardiac tamponade were found for low-, mid-, and high-volume centers, as well as for centers with and without onsite cardiac surgery.
CONCLUSION CONCLUSIONS
While center volume and onsite cardiac surgery do not impact patient selection, there are differences in ablation spectrum, infrastructure, periprocedural safety precautions, and treatment of tamponade.

Identifiants

pubmed: 37526378
doi: 10.1002/clc.24096
pmc: PMC10577558
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1210-1219

Informations de copyright

© 2023 The Authors. Clinical Cardiology published by Wiley Periodicals LLC.

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Auteurs

Laura Rottner (L)

Department of Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany.

Stefan Reubold (S)

Department of Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany.

Sophie Schönhofer (S)

Asklepios Klinik Harburg, Hamburg, Germany.

Bruno Reißmann (B)

Department of Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany.

Feifan Ouyang (F)

Department of Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany.

Julius Obergassel (J)

Department of Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany.

Ilaria My (I)

Department of Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany.

Fabian Moser (F)

Department of Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany.

Jan-Per Wenzel (JP)

Department of Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany.

Marc Lemoine (M)

Department of Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany.

Daniel Steven (D)

University Heart Center, University of Cologne, Cologne, Germany.

Philipp Sommer (P)

Herz- und Diabeteszentrum NRW, Bad Oeynhausen, Ruhr-University of Bochum, Bad Oeynhausen, Germany.

Paulus Kirchhof (P)

Department of Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany.
DZHK, partner site Hamburg/Kiel/Lübeck, Hamburg, Germany.
Institute of Cardiovascular Sciences, University of Birmingham, Birmingham, UK.

Andreas Rillig (A)

Department of Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany.

Andreas Metzner (A)

Department of Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany.

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