Use of a novel multi-disciplinary meeting to aid decision making for cardiac implantable electronic devices and the management of patients with arrhythmias

Abstract

Abstract Funding Acknowledgements Type of funding sources: None. Background Heart team meetings are well established for the management of coronary artery disease. We recently developed a novel weekly multi-disciplinary meeting (MDM) to aid decision making in the selection of patients suitable for treatment with cardiac implantable electronic devices (CIEDs) and the management of patients with arrhythmias. In this study, we present the results of an audit of the service. Purpose To illustrate the workload, range of conditions and decisions, and electronic communication used in the MDM. Methods Patients from all of Northern Ireland can be listed for discussion at the meeting using the Northern Ireland Electronic Clinical Record (NIECR). The same electronic record is used to log the result of the discussion (Figure 1). These records were analyzed for all patients discussed at the meeting from August 2019 to March 2021. Demographic and outcome (decision and mortality) data were recorded. Results A total of 614 patients were discussed (median age 63.0 years, 68.2% male). The mean weekly number of patients discussed was 7.5 per week. A total of 621 decision outcomes were made. 37 patients (6.0%) had died at the time of data collection. A summary of the major disease for discussion and outcome from discussion is shown in Figure 2. Conclusion A wide variety of patients, diseases and issues were discussed over this period. Conduction system disease was the most common disease, highlighting the challenges in treating this population. Furthermore, the most common outcome from discussion was conservative management. This may reflect the fact that arrhythmias are now frequently detected in asymptomatic patients without structural heart disease. This small study clearly demonstrates that there is interest in such a meeting to help in the management of these complex patients.