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INTRODUCTION The frequency of catheter ablation for atrial fibrillation (AF) has increased dramatically, stretching resources. Discharge on the same day as treatment may increase the efficiency and throughput. There are limited data regarding the safety of this strategy. METHODS We performed a retrospective analysis of consecutive patients undergoing AF ablation in a tertiary centre and in a district general hospital, and identified those discharged on the same day of treatment. The safety endpoint was any complication and/or presentation to hospital in the 48-hours and at 30 days post discharge. We performed an economic analysis to calculate potential cost saving. RESULTS Among a total population of 2628 patients, we identified 727 subjects (61.1±12.5 years, 69.6% male) undergoing day-case AF ablation. Cryoballoon technique was used in 79.2% of the day-cases, and 91.6% of the procedures were performed under conscious sedation. 1.8% (13) of the participants met the safety composite endpoint at 48-hour, however only 0.7% (5) required at least one day of hospitalisation. Bleeding/haematoma at the femoral access site (0.5%) and pericarditic chest pain (0.5%) were the main reasons for readmission. None experienced cardiac tamponade or other life-threatening complications in the 48-hours post-discharge. Overall rate of complication and/or presentation to hospital at 30 days was 3.7%. Our day-case policy resulted in an annual cost-saving of approximately of £83,927 for our hospital. CONCLUSION In this large multicentre cohort, same-day discharge in selected patients following AF ablation appears to be safe and cost-effective, with a very low rate of early readmission or post-discharge complication. This article is protected by copyright. All rights reserved.
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Journal_of_cardiovascular_electrophysiology
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Same-day discharge following catheter ablation of atrial fibrillation: a safe and cost-effective approach.
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