PURPOSE: To assess the feasibility and safety of same-day discharge after S-ICD implantation by implementing a specific analgesia protocol and phone follow-up. METHODS: Consecutive patients presenting for outpatient S-ICD implantation were enrolled between 1/1/2018 and 4/30/2019. An analgesia protocol included pre-operative acetaminophen and oxycodone, intraoperative local bupivacaine, and limited use of oxycodone-acetaminophen at discharge. The primary outcome was successful same-day discharge. Numerical Pain Rating Scale (NPRS) on postoperative day (POD) 1, 3, 14, and 30 and any unplanned health care visits during the 1-month follow-up period were assessed. RESULTS: Out of 53 potentially eligible S-ICD patients, 49 patients (92.5%) were enrolled and successfully discharged on the same day. Mean age of these 49 patients was 47 ± 14 years. There were no acute procedural complications. Severe pain (NPRS ≥ 8) on POD 0, 1, and 3 was present in 14.3%, 14.3%, and 8.2% of patients, respectively. The total in-hospital stay was 534 ± 80 min. Four unplanned visits (8%) due to cardiac or device-related issues occurred during 1-month follow-up, including 2 patients with heart failure exacerbation, one patient with an incisional infection, and one patient with inappropriate shocks. CONCLUSIONS: With the appropriate institutional protocol including specific analgesics and phone follow-up, same-day discharge after outpatient S-ICD implantation is feasible and appears safe for most patients.. Device-related pain can be severe in the first 3 days post-implantation and can be successfully treated with limited supply of narcotic medications.
PURPOSE: To assess the feasibility and safety of same-day discharge after S-ICD implantation by implementing a specific analgesia protocol and phone follow-up. METHODS: Consecutive patients presenting for outpatient S-ICD implantation were enrolled between 1/1/2018 and 4/30/2019. An analgesia protocol included pre-operative acetaminophen and oxycodone, intraoperative local bupivacaine, and limited use of oxycodone-acetaminophen at discharge. The primary outcome was successful same-day discharge. Numerical Pain Rating Scale (NPRS) on postoperative day (POD) 1, 3, 14, and 30 and any unplanned health care visits during the 1-month follow-up period were assessed. RESULTS: Out of 53 potentially eligible S-ICD patients, 49 patients (92.5%) were enrolled and successfully discharged on the same day. Mean age of these 49 patients was 47 ± 14 years. There were no acute procedural complications. Severe pain (NPRS ≥ 8) on POD 0, 1, and 3 was present in 14.3%, 14.3%, and 8.2% of patients, respectively. The total in-hospital stay was 534 ± 80 min. Four unplanned visits (8%) due to cardiac or device-related issues occurred during 1-month follow-up, including 2 patients with heart failure exacerbation, one patient with an incisional infection, and one patient with inappropriate shocks. CONCLUSIONS: With the appropriate institutional protocol including specific analgesics and phone follow-up, same-day discharge after outpatient S-ICD implantation is feasible and appears safe for most patients.. Device-related pain can be severe in the first 3 days post-implantation and can be successfully treated with limited supply of narcotic medications.
Authors: Raul Weiss; Bradley P Knight; Michael R Gold; Angel R Leon; John M Herre; Margaret Hood; Mayer Rashtian; Mark Kremers; Ian Crozier; Kerry L Lee; Warren Smith; Martin C Burke Journal: Circulation Date: 2013-08-27 Impact factor: 29.690
Authors: Michael R Gold; Johan D Aasbo; Mikhael F El-Chami; Mark Niebauer; John Herre; Jordan M Prutkin; Bradley P Knight; Steven Kutalek; Kevin Hsu; Raul Weiss; Eric Bass; Michael Husby; Timothy M Stivland; Martin C Burke Journal: Heart Rhythm Date: 2017-05-11 Impact factor: 6.343
Authors: Daniel J Friedman; Craig S Parzynski; Paul D Varosy; Jordan M Prutkin; Kristen K Patton; Ali Mithani; Andrea M Russo; Jeptha P Curtis; Sana M Al-Khatib Journal: JAMA Cardiol Date: 2016-11-01 Impact factor: 14.676
Authors: Sana M Al-Khatib; William G Stevenson; Michael J Ackerman; William J Bryant; David J Callans; Anne B Curtis; Barbara J Deal; Timm Dickfeld; Michael E Field; Gregg C Fonarow; Anne M Gillis; Christopher B Granger; Stephen C Hammill; Mark A Hlatky; José A Joglar; G Neal Kay; Daniel D Matlock; Robert J Myerburg; Richard L Page Journal: J Am Coll Cardiol Date: 2018-08-16 Impact factor: 24.094
Authors: Michael K Essandoh; George E Mark; Johan D Aasbo; Charles A Joyner; Saumya Sharma; Beningo F Decena; Eric D Bolin; Raul Weiss; Martin C Burke; Timothy R McClernon; Emile G Daoud; Michael R Gold Journal: Pacing Clin Electrophysiol Date: 2018-06-08 Impact factor: 1.976