Same-day Discharge After Atrial Fibrillation Ablation

Overview

Journal Heliyon

Specialty Social Sciences

Date 2023 Dec 4

PMID 38045193

Authors

Jose Aguilera

Erika Hutt

Ruth Madden

Mohamed Kanj

Walid Saliba

John Rickard

Jakub Sroubek

Thomas Callahan

Mina Chung

Brian Baranowski

David Martin

Thomas Dresing

Oussama M Wazni

Ayman Hussein

Daniel Cantillon

Divyang Patel

Shady Nakhla

Tyler Taigen

Affiliations

Soon will be listed here.

Abstract

Background: Atrial fibrillation (AF) catheter ablation has become an increasingly effective and safe strategy for the management of AF. With increased safety of catheter ablation, same-day discharge (SDD) is a potential way to minimize health care resource utilization and improve patient experience.

Objective: To evaluate the safety and patient satisfaction of SDD after contemporary AF ablation.

Methods: Consecutive patient undergoing AF ablation at our institution between 1/2020 and 10/2021 were enrolled in registry for clinical, quality, procedural and outcomes data. Patients were considered for SDD per physician discretion and patients' preference based upon clinical evaluation. Adjudicated ninety-day major complications, thirty-day adverse events, and thirty-day re-admissions were collected in a prospective registry for all patients.

Results: A total of 2142 consecutive patients underwent elective AF ablation during the study period. After excluding cases with missing data, 1830 patients were included in the analysis. Of those, 350 (19 %) patients were discharged the same day (SDD group) and 1480 (81 %) stayed overnight. Patients in the SDD group compared to overnight stay group were younger, more likely to be male, White patients, lower CHA2DS2-VASc score and to be on lower rates of warfarin as an anticoagulation strategy. After propensity score matching, SDD was associated with lower rate of major complications and higher patient satisfaction. The majority of life-treating complications occurred interprocedurally or within 6 h of procedure termination.

Conclusion: The present study demonstrated that SDD after contemporary AF ablation is feasible, safe and associated with higher patient satisfaction using a proposed SDD pathway and criteria.

Citing Articles

Micro-Costing Analysis for the Treatment of Atrial Fibrillation: An Economic Evaluation of the First Italian Experience of Same-Day Discharge Protocol for Cryoballoon Atrial Fibrillation Ablation.

Sgarito G, Cascino A, Ferrara G, Conti S J Clin Med. 2024; 13(10).

PMID: 38792377 PMC: 11122004. DOI: 10.3390/jcm13102836.

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