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Use of cryoballoon catheter may confer labor, resource efficiencies
A model developed from data from the VALUE PVI study indicates that use of a cryoballoon for catheter ablation may save overtime and use less time in the electrophysiology lab.
In the main results of VALUE PVI, published in June 2014, researchers found that use of a cryoballoon (Arctic Front, Medtronic) for catheter ablation in patients with atrial fibrillation reduced laboratory occupancy time, procedure time and fluoroscopy time compared with use of radiofrequency catheter ablation (Deville JB, et al. J Invasive Cardiol. 2014;26:268-272).
In a new analysis, Marcin Kowalski, MD, and colleagues attempted to determine the economic value associated with the VALUE PVI results indicating shorter AF ablation times when the cryoballoon was used.
Marcin Kowalski
Using discrete event simulation, they constructed a model translating the procedural efficiencies determined in VALUE PVI into metrics used by hospital administrators.
They simulated a 1,000-day period to determine the effect of those efficiencies on hospital staff and resources.
Kowalski, from Staten Island University Hospital, Norwell Health, Staten Island, New York, and colleagues found that use of the cryoballoon catheter reduced the number of days with overtime (cryoballoon, 60 days; radiofrequency, 422 days; absolute decrease, 36.2%) and the cumulative overtime hours (cryoballoon, 27 hours; radiofrequency, 370 hours; reduction, 92.7%).
They also found that use of the cryoballoon increased the number of days that added time for additional usage of the electrophysiology lab (cryoballoon, 653 days; radiofrequency, 186 days; absolute increase, 46.7%).
When cryoballoon ablation was performed, there were fewer days in which the end time of one ablation procedure interfered with the scheduled start time of another (cryoballoon, 461 days; radiofrequency, 554 days; absolute decrease, 9.3%), according to the researchers.
“The decrease in overtime and increased predictability of procedure time/duration associated with the cryoballoon procedure may have positive benefits on overall hospital resources, including the ability to treat additional patients, the potential to reduce job stress on the [electrophysiology] staff ... and the potential to reduce support staff burnout and turnover,” Kowalski and colleagues wrote. – by Erik Swain
Disclosure: Kowalski reports receiving compensation for physician teaching programs from Medtronic. Please see the full study for a list of the other researchers’ relevant financial disclosures.