Evidence map›Paper›PMID 36537305›Full record

ArticleJournal of medical economics

Improved hospital discharge and cost savings with esophageal cooling during left atrial ablation.

Christopher Joseph, Julie Cooper, Rishi Sikka, Jason Zagrodzky, Robert W Turer, Samuel A McDonald, Erik Kulstad, James Daniels

Abstract read
In one paragraph

Article in Journal of medical economics. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Review
  2. How to ablate the septo-pulmonary bundle: a case-based review of percutaneous ablation strategies to achieve roof line block.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2023
    Article
  3. Letter to the editor: oesophageal cooling for protection during left atrial ablations.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2023
    Article
  4. Review
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Christopher JosephUniversity of Texas Southwestern Medical Center, Dallas, TX, USA.ORCID 0000-0001-9902-3445
Julie CooperUniversity of Texas Southwestern Medical Center, Dallas, TX, USA.ORCID 0000-0002-3509-0515
Rishi SikkaPolicy and Practice, Brown University School of Public Health, Providence, RI, USA.ORCID 0000-0002-6954-1951
Jason ZagrodzkyTexas Cardiac Arrhythmia Institute, St. David's South Austin Medical Center, Austin, TX, USA.ORCID 0000-0002-0078-5309
Robert W TurerUniversity of Texas Southwestern Medical Center, Dallas, TX, USA.ORCID 0000-0003-1387-640X
Samuel A McDonaldUniversity of Texas Southwestern Medical Center, Dallas, TX, USA.ORCID 0000-0002-8383-3854
Erik KulstadUniversity of Texas Southwestern Medical Center, Dallas, TX, USA.ORCID 0000-0002-9331-8266
James DanielsUniversity of Texas Southwestern Medical Center, Dallas, TX, USA.ORCID 0000-0003-3360-6175

Funding

Utility of Esophageal Cooling Therapy for the Prevention of Thermal Injury During Atrial FibrillationR44HL158375 · NHLBI · ADVANCED COOLING THERAPY, LLC · PI CALLANS, DAVID J, KULSTAD, ERIK BENJAMIN · 2021 to 2023
$3.8M
NHLBI NIH HHS R44 HL158375
6 · The paper itself

Abstract

backgroundLeft atrial ablation to obtain pulmonary vein isolation (PVI) for the treatment of atrial fibrillation (AF) is a technologically intensive procedure utilizing innovative and continually improving technology. Changes in the technology utilized for PVI can in turn lead to changes in procedure costs. Because of the proximity of the esophagus to the posterior wall of the left atrium, various technologies have been utilized to protect against thermal injury during ablation. The impact on hospital costs during PVI ablation from utilization of different technologies for esophageal protection during ablation has not previously been evaluated.

objectiveTo compare the costs of active esophageal cooling to luminal esophageal temperature (LET) monitoring during left atrial ablation.

methodsWe performed a time-driven activity-based costing (TDABC) analysis to determine costs for PVI procedures. Published data and literature review were utilized to determine differences in procedure time and same-day discharge rates using different esophageal protection technologies and to determine the cost impacts of same-day discharge versus overnight hospitalization after PVI procedures. The total costs were then compared between cases using active esophageal cooling to those using LET monitoring.

resultsThe effect of implementing active esophageal cooling was associated with up to a 24.7% reduction in mean total procedure time, and an 18% increase in same-day discharge rate. TDABC analysis identified a $681 reduction in procedure costs associated with the use of active esophageal cooling after including the cost of the esophageal cooling device. Factoring in the 18% increase in same-day discharge resulted in an increased cost savings of $2,135 per procedure.

conclusionsThe use of active esophageal cooling is associated with significant cost-savings when compared to traditional LET monitoring, even after accounting for the additional cost of the cooling device. These savings originate from a per-patient procedural time savings and a per-population improvement in same-day discharge rate.

Indexed as

Atrial FibrillationCatheter AblationCost SavingsEsophagusHeart AtriaHumansPatient DischargeTreatment Outcomeatrial fibrillationatrioesophageal fistulaesophageal coolingII1I19luminal esophageal temperature monitoringMM5M50Pulmonary vein isolationradiofrequency ablationtime-driven activity-based costing

Identifiers

PMID36537305
PMCPMC10238148

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.