title: Healthcare personnel resource burden related to in-clinic follow-up of cardiovascular implantable electronic devices: a European Heart Rhythm Association and Eucomed joint survey.
abstract: OBJECTIVE
  A pilot European survey was conducted to assess the cumulative time spent by healthcare personnel for in-office follow-up of cardiac implantable electrical devices (CIEDs), including cardiac pacemakers, implantable cardioverter-defibrillators, and cardiac resynchronization therapy (CRT) devices.
  
  
  RESULTS
  Resource use data were collected during a session of in-clinic follow-up. Among 407 visits, 93% were scheduled and 7% unscheduled. Visit duration (total cumulative time) lasted a mean of 27 min for scheduled visits, and was ∼30% longer for unscheduled visits. Independent determinants of visit duration were: unscheduled visit (+7.6 min, P = 0.01), the need for device reprogramming (+7.5 min, P < 0.001), and the type of device checked, with CRT devices needing 9.1 and 6.6 more minutes than single- (P < 0.001) and dual-chamber devices (P = 0.002), respectively. Most visits involved two different types of healthcare personnel (239 of 407, 59%), simultaneously. The most frequent combination was the involvement of both a cardiologist and a nurse (216 of 407 visits with both of them only, and 65 additional visits with also an internal technician, an external technician, or both). Overall, an external technician was involved in 18% of visits.
  
  
  CONCLUSIONS
  In 'real-world' practice, the follow-up of CIEDs nowadays requires important resources in terms of time dedicated by specialized personnel, corresponding to cardiologists, nurses, internal technicians, and external, industry-employed technicians. These observations should be the basis for addressing clinical, organizational, financial, and policy initiatives targeted to optimize follow-up procedures in order to face the increase in the number of patients treated with CIEDs expected for the next years.
authors.affiliation: Institute of Cardiology, University of Bologna, Azienda Ospedaliera S. Orsola-Malpighi, Via Massarenti 9, 40138 Bologna, Italy. giuseppe.boriani@unibo.it
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Boriani
authors.forename: Angelo
authors.initials: A
authors.lastname: Auricchio
authors.forename: Catherine
authors.initials: C
authors.lastname: Klersy
authors.forename: Paulus
authors.initials: P
authors.lastname: Kirchhof
authors.forename: Josep
authors.initials: J
authors.lastname: Brugada
authors.forename: John
authors.initials: J
authors.lastname: Morgan
authors.forename: Panos
authors.initials: P
authors.lastname: Vardas
mesh_terms: D000488:Allied Health Personnel / Q000706:statistics & numerical data; D001071:Appointments and Schedules; D058406:Cardiac Resynchronization Therapy / Q000706:statistics & numerical data; D002309:Cardiology / Q000706:statistics & numerical data*; D016208:Databases, Factual / Q000706:statistics & numerical data; D017147:Defibrillators, Implantable / Q000706:statistics & numerical data*; D005060:Europe; D005500:Follow-Up Studies; D019538:Health Care Surveys; D006280:Health Workforce / Q000706:statistics & numerical data*; D006801:Humans; D010044:Outpatient Clinics, Hospital / Q000706:statistics & numerical data; D010138:Pacemaker, Artificial / Q000706:statistics & numerical data*; D013041:Specialties, Nursing / Q000706:statistics & numerical data