Safety and efficiency of emergency department interrogation of cardiac devices.
OBJECTIVE
Patients with implanted cardiac devices may wait extended periods for interrogation in emergency departments (EDs). Our purpose was to determine if device interrogation could be done safely and faster by ED staff.


METHODS
Prospective randomized, standard therapy controlled, trial of ED staff device interrogation vs. standard process (SP), with 30-day follow-up. Eligibility criteria: ED presentation with a self-report of a potential device related complaint, with signed informed consent. SP interrogation was by company representative or hospital employee.


RESULTS
Of 60 patients, 42 (70%) were male, all were white, with a median (interquartile range) age of 71 (64 to 82) years. No patient was lost to follow up. Of all patients, 32 (53%) were enrolled during business hours. The overall median (interquartile range) ED vs. SP time to interrogation was 98.5 (40 to 260) vs. 166.5 (64 to 412) minutes (P=0.013). While ED and SP interrogation times were similar during business hours, 102 (59 to 138) vs. 105 (64 to 172) minutes (P=0.62), ED interrogation times were shorter vs. SP during non-business hours; 97 (60 to 126) vs. 225 (144 to 412) minutes, P=0.002, respectively. There was no difference in ED length of stay between the ED and SP interrogation, 249 (153 to 390) vs. 246 (143 to 333) minutes (P=0.71), regardless of time of presentation. No patient in any cohort suffered an unplanned medical contact or post-discharge adverse device related event.


CONCLUSIONS
ED staff cardiac device interrogations are faster, and with similar 30-day outcomes, as compared to SP.
Department of Emergency Medicine, Genesis Health Care Systems, Zanesville, OH, USA.
James F
JF
Neuenschwander
Department of Emergency Medicine, Baylor College of Medicine, Houston, TX, USA.
W Frank
WF
Peacock
Department Cardiology, Genesis Health Care Systems, Zanesville, OH, USA.
Madgy
M
Migeed
Department of Radiology, The Cleveland Clinic Foundation, Cleveland, OH, USA.
Sara A
SA
Hunter
Department of Cell Biology and Physiology, Ohio State University Wexner Medical Center, Columbus, OH, USA.
John C
JC
Daughtery
Ohio State University, Columbus, OH, USA.
Ian C
IC
McCleese
Department of Emergency Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA.
Brian C
BC
Hiestand
Defibrillators, implantable; Emergency medicine; Interrogation; Pacemaker; Safety