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Aritmologia in Campania

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Feasibility and Safety of Same-Day Discharge after Implantable Cardioverter Defibrillator Placement for Primary Prevention

SABA DARDA, M.D.,* YAZAN KHOURI, M.D.,* RONY GORGES, M.D.,* MERSHED AL SAMARA, M.D.,† SACHIN K. AMRUTHLAL JAIN, M.D.,* MARCOS DACCARETT, M.D., M.SC.,* and CHRISTIAN MACHADO, M.D.*

Background: In the current age of ever-increasing healthcare costs, it is of utmost importance to adopt
strategies that reduce hospital stay and cost, while still maintaining patient safety. In this study we review
our approach of same-day discharge following implantable cardioverter defibrillator (ICD) placement for
primary prevention of sudden cardiac death (SCD).
Methods: We conducted a retrospective chart review of 415 consecutive patients who underwent ICD
implantation for prevention of SCD between 2007 and 2010. Patients were divided into an outpatient group
(Group A) and an inpatient group (Group B). We evaluated the patients’ demographics, comorbidities,
and the rate of short-term surgical complications on or before the 2-week follow-up appointment.
Results: Of 252 patients included in Group A, 198 (78.6%) were successfully discharged on the same day
(Group A1). At the 2-week wound check appointment, four patients (2%) had minor surgical site bleeding,
one patient had a hematoma, and one patient developed fever and swelling around the implantation
site. Of the Group A patients, 54 (21.4%) were not discharged on the same day (Group A2). A total of
53 patients were included in Group B, four (7.5%) developed a hematoma at the 2-week follow-up wound
check visit.
Conclusions: Procedure-related complications after ICD placement are rare. Same-day discharge is safe
and feasible following ICD placement for primary prevention of SCD and hence a reduction in healthcare
costs can be achieved by decreasing the length of hospital stay. (PACE 2013; 00:1–7)
discharge, implantable cardioverter defibrillator, safety, same day

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