Abstract：
BACKGROUND: Cryoballoon ablation for treatment of atrial fibrillation (AF) reduces procedure times, but limited data is available about its impact on electrophysiology (EP) lab efficiency in Central and Eastern Europe (CEE). Using CEE-specific procedure data, the present study modeled cryoballoon ablation procedures on EP lab resource consumption to improve efficiency.
METHODS: A discrete event simulation model was developed to assess EP efficiency with cryoballoon ablation. Model inputs were taken from CEE sites within the Cryo Global Registry, namely Czech Republic, Hungary, Poland, Serbia, and Slovakia. The main endpoints were percentage of days that resulted in overtime and percentage of days with time for one extra simple EP procedure. Use of the \'figure of 8\' (Fo8) closure technique to reduce procedure time was also examined.
RESULTS: The mean lab occupancy time across all CEE sites was 133 ± 47 minutes (min: 104 minutes, max:181 minutes). Cryoballoon ablation in the base-case scenario resulted in 14.6% of days with overtime and 64.8% of days with time for an extra simple EP procedure. Use of the Fo8 closure technique enhanced these values to 5.5% and 85.3%, respectively. Model endpoints were most sensitive to changes in lab occupancy times and overtime start time.
CONCLUSIONS: In this CEE-specific analysis of EP lab efficiency it was found that 3 cryoballoon ablation procedures could be performed in 1 lab day, leaving time for a 4th simple EP procedure on most days. As such, use cryoballoon ablation for PVI is an effective way to improve EP lab efficiency.
METHODS: A discrete event simulation model was developed to assess EP efficiency with cryoballoon ablation. Model inputs were taken from CEE sites within the Cryo Global Registry, namely Czech Republic, Hungary, Poland, Serbia, and Slovakia. The main endpoints were percentage of days that resulted in overtime and percentage of days with time for one extra simple EP procedure. Use of the \'figure of 8\' (Fo8) closure technique to reduce procedure time was also examined.
RESULTS: The mean lab occupancy time across all CEE sites was 133 ± 47 minutes (min: 104 minutes, max:181 minutes). Cryoballoon ablation in the base-case scenario resulted in 14.6% of days with overtime and 64.8% of days with time for an extra simple EP procedure. Use of the Fo8 closure technique enhanced these values to 5.5% and 85.3%, respectively. Model endpoints were most sensitive to changes in lab occupancy times and overtime start time.
CONCLUSIONS: In this CEE-specific analysis of EP lab efficiency it was found that 3 cryoballoon ablation procedures could be performed in 1 lab day, leaving time for a 4th simple EP procedure on most days. As such, use cryoballoon ablation for PVI is an effective way to improve EP lab efficiency.
摘要：
背景：冷冻球囊消融治疗心房颤动（AF）可缩短手术时间，但有关其对中欧和东欧（CEE）电生理（EP）实验室效率的影响的数据有限。使用CEE特定的程序数据，本研究对EP实验室资源消耗的冷冻球囊消融程序进行了建模，以提高效率。
方法：开发了离散事件模拟模型来评估冷冻球囊消融的EP效率。模型输入来自Cryo全球登记处的CEE站点，即捷克共和国，匈牙利,波兰,塞尔维亚,斯洛伐克。主要终点是导致加班的天数百分比和一个额外的简单EP程序随时间的天数百分比。还检查了使用\'8\'（Fo8）闭合技术来减少手术时间。
结果：所有CEE站点的平均实验室占用时间为133±47分钟（分钟：104分钟，最大：181分钟）。在基本情况下，冷冻球囊消融导致14.6％的超时天数和64.8％的额外简单EP程序的时间。使用Fo8闭合技术将这些值提高到5.5％和85.3％，分别。模型终点对实验室占用时间和加班开始时间的变化最敏感。
结论：在这项针对CEE的EP实验室效率的分析中，发现可以在1个实验室天进行3次冷冻球囊消融手术，在大多数日子里，为第4次简单EP手术留出时间。因此，使用冷冻球囊消融治疗PVI是提高EP实验室效率的有效途径。
方法：开发了离散事件模拟模型来评估冷冻球囊消融的EP效率。模型输入来自Cryo全球登记处的CEE站点，即捷克共和国，匈牙利,波兰,塞尔维亚,斯洛伐克。主要终点是导致加班的天数百分比和一个额外的简单EP程序随时间的天数百分比。还检查了使用\'8\'（Fo8）闭合技术来减少手术时间。
结果：所有CEE站点的平均实验室占用时间为133±47分钟（分钟：104分钟，最大：181分钟）。在基本情况下，冷冻球囊消融导致14.6％的超时天数和64.8％的额外简单EP程序的时间。使用Fo8闭合技术将这些值提高到5.5％和85.3％，分别。模型终点对实验室占用时间和加班开始时间的变化最敏感。
结论：在这项针对CEE的EP实验室效率的分析中，发现可以在1个实验室天进行3次冷冻球囊消融手术，在大多数日子里，为第4次简单EP手术留出时间。因此，使用冷冻球囊消融治疗PVI是提高EP实验室效率的有效途径。
