Utilization and perception of same-day discharge in electrophysiological procedures and device implantations: an EHRA survey.

The aim of this European Heart Rhythm Association (EHRA) survey was to assess the utilization of same-day discharge (SDD) in electrophysiology (EP). An online-based questionnaire was shared with the EHRA community between 12 and 30 June 2020 and recorded institutional information, complication assessment, recent experiences, and opinions regarding possible advantages or concerns with SDD. In total, 218 responses from 49 countries provided information on current SDD management. Overall, SDD was implemented in 77.5%, whereas this proportion was significantly higher in tertiary and high-volume centres (83.8% and 85.3%, both P < 0.01). The concept of SDD was most commonly used following implantations of cardiac event recorders (97%), diagnostic EP procedures (72.2%), and implantations of pacemakers with one or two intracardiac leads (50%), while the lowest SDD utilization was observed after catheter ablations of left atrial or ventricular arrhythmias. Within SDD-experienced centres, ∼90% respondents stated that this discharge concept is recommendable or highly recommendable and reported that rates of increased rehospitalization and complication rates were low. Most respondents assumed a better utilization of hospital resources (78.2%), better cost effectiveness (77.3%), and an improved patients' comfort but were concerned about possible impairment of detection (72.5%) and management (78.7%) of late complications. In conclusion, >75% of respondents already implement SDD following EP interventions with a large heterogeneity with regard to specific procedures. Further research is needed to confirm or disprove existing and expected benefits and obstacles.

Length of the QT interval: determinants and prognostic implications in a population-based prospective study of older men.

OBJECTIVE: We examined potential determinants and prognostic value of the corrected QT interval (QTc). DESIGN: A total of 4252 British men aged 60 to 79 years had a resting 12-lead electrocardiogram. Potential determinants of the QTc were assessed using multivariable regression. Men were followed up for 7 years. RESULTS: A 1 standard deviation increase in QTc (26 milliseconds) was associated with increased all-cause mortality (hazard ratio, 1.13; 95% confidence interval, 1.05-1.22). Longer QTc was associated with increasing age, preexisting coronary heart disease, and a range of drugs. Shorter QTc was present in diabetics and smokers. Corrected QT interval was related inversely with serum potassium and calcium and positively with serum urate, sodium, and systolic blood pressure. The relation of QTc to all-cause mortality was independent of adjustment for these factors. CONCLUSIONS: Age, preexisting coronary heart disease, certain medications and biochemical factors, and diabetes are independently associated with QTc. Corrected QT interval is an independent predictor of all-cause mortality.