Process optimization for atrial fibrillation ablation.
Aims: In the light of an increasing prevalence of atrial fibrillation (AF) and growing evidence for the superiority of early invasive rhythm control, the demand for ablation therapy is rising. Accordingly, ablation centres will have to maximize their capacity by either adding electrophysiology labor...
| Published in: | EP: Europace Vol. 24; no. 11; pp. 1763 - 1769 |
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| Main Authors: | , , , , , , , , |
| Format: | research tables/charts Journal Article |
| Published: |
Oxford University Press / USA
Nov2022
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=160396786&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 160396786 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 10995129 NYF jtl: EP: Europace issn: 10995129 maglogo: N pubinfo: dt: Nov2022 vid: 24 iid: 11 pid: 622 pub: Oxford University Press / USA artinfo: ui: 160396786 160396786 NLM35989514 160396786 10.1093/europace/euac048 NLM35989514 160396786 ppf: 1763 ppct: 6 formats: tig: atl: Process optimization for atrial fibrillation ablation. aug: au: Boehmer, Andreas A Summ, Alena Vila, Steffen Rothe, Moritz Nussbaum, Elena Zezyk, Celine Dobre, Bianca C Kaess, Bernhard Ehrlich, Joachim R affil: Department of Cardiology, St Josefs-Hospital Wiesbaden , Beethovenstraße 20, 65189 Wiesbaden , Germany sug: subj: Atrial Fibrillation Epidemiology Catheter Ablation Adverse Effects Pulmonary Veins Surgery Atrial Fibrillation Surgery Atrial Fibrillation Diagnosis Cryosurgery Methods Catheter Ablation Methods Recurrence Treatment Outcomes Human ab: Aims: In the light of an increasing prevalence of atrial fibrillation (AF) and growing evidence for the superiority of early invasive rhythm control, the demand for ablation therapy is rising. Accordingly, ablation centres will have to maximize their capacity by either adding electrophysiology laboratory resources or optimizing process management. In order to optimize process management, we applied "Lean Six Sigma" method to a single ablation center. We compared procedural parameters, acute efficacy and safety of cryoballoon pulmonary vein isolation (cryoPVI) before and after modifications.Methods and Results: Patients (n = 713) undergoing cryoPVI (108 before and 605 after process optimization) were analysed. Within 3 years of process optimization, electrophysiology laboratory occupancy time (150.7 ± 44.4 vs. 94 ± 22.1 min, P < 0.001), procedure time (84.5 ± 21-47.4 ± 12 min, P < 0.001), left-atrial dwell time (53.9 ± 18.4-31.9 ± 9.9 min, P < 0.001), and fluoroscopy time (15.8 ± 5.1 vs. 6.2 ± 2.8 min, P < 0.001) decreased. Contrast dye use (116 ± 35 vs. 27 ± 15 mL, P < 0.001) and radiation dose (893 ± 1078 vs. 253 ± 249 cGy cm2, P < 0.001) were reduced by ∼77 and ∼72%, respectively. There was no difference in safety endpoint occurrence (3.7 vs. 1.5%, P = 0.11).Conclusion: The process optimization of cryoPVI for AF therapy using the 'Lean Six Sigma' method significantly increases efficiency without compromising patient safety. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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