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Multicenter Study
. 2021 Feb;32(2):183-190.
doi: 10.1111/jce.14843. Epub 2020 Dec 29.

Same-day discharge after cryoballoon ablation of atrial fibrillation: A multicenter experience

Marcin Kowalski  1 , Valay Parikh  1 , Jose R Salcido  2 , Nagib Chalfoun  2 , Alfred Albano  2 , Padraig G O'Neill  3 , Mark R Bowers  3 , Andre Gauri  2 , Kendra M Braegelmann  4 , Hae W Lim  4 , Philippe Akhrass  1 , Rina Shah  1 , Soad Bekheit  1 , Laurence M Epstein  1 , Arash Aryana  3
Affiliations
Multicenter Study

Same-day discharge after cryoballoon ablation of atrial fibrillation: A multicenter experience

Marcin Kowalski et al. J Cardiovasc Electrophysiol. 2021 Feb.

Abstract

Background: It is common practice to observe patients during an overnight stay (ONS) following a catheter ablation procedure for the treatment of atrial fibrillation (AF).

Objectives: To investigate the safety and economic impact of a same-day discharge (SDD) protocol after cryoballoon ablation for treatment of AF in high-volume, geographically diverse US hospitals.

Methods: We retrospectively reviewed 2374 consecutive patients (1119 SDD and 1180 ONS) who underwent cryoballoon ablation for AF at three US centers. Baseline characteristics, acute procedure-related complications, and longer-term evaluations of safety were recorded during routine clinical follow-up. The mean cost of an ONS was used in a one-way sensitivity analysis to evaluate yearly cost savings as a function of the percentage of SDD cases per year.

Results: The SDD and ONS cohorts were predominately male (69% vs. 67%; p = .3), but SDD patients were younger (64 ± 11 vs. 66 ± 10; p < .0001) with lower body mass index (30 ± 6 vs. 31 ± 61; p < .0001) and CHA2 DS2 -VASc scores (1.4 ± 1.0 vs. 2.2 ± 1.4; p < .0002). There was no difference between SDD and ONS in the 30-day total complication rate (n = 15 [1.26%] versus n = 24 [2.03%]; p = .136, respectively). The most common complication was hematoma in both the SDD (n = 8; 0.67%) and ONS (n = 11; 0.93%) cohorts. Sensitivity analysis demonstrated that when 50% of every 100 patients treated were discharged the same day, hospital cost savings ranged from $45 825 to $83 813 per year across US hospitals.

Conclusions: SDD following cryoballoon ablation for AF appears to be safe and is associated with cost savings across different US hospitals.

Keywords: atrial fibrillation; catheter ablation; cryoballoon; hospital discharge; same day discharge.

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References

REFERENCES

    1. Calkins H, Hindricks G, Cappato R, et al. 2017 HRS/EHRA/ECAS/APHRS/SOLAECE expert consensus statement on catheter and surgical ablation of atrial fibrillation: Executive summary. Heart Rhythm. 2017;14:e445-e494.
    1. Abdelnoor M, Andersen JG, Arnesen H, Johansen O. Early discharge compared with ordinary discharge after percutaneous coronary intervention-a systematic review and meta-analysis of safety and cost. Vasc Health Risk Manag. 2017;13:101-109.
    1. Darda S, Khouri Y, Gorges R, et al. Feasibility and safety of same-day discharge after implantable cardioverter defibrillator placement for primary prevention. Pacing Clin Electrophysiol. 2013;36:885-891.
    1. Ignacio DM, Jarma DJJ, Nicolas V, et al. Current safety of pulmonary vein isolation in paroxysmal atrial fibrillation: first experience of same-day discharge. J Atr Fibrillation. 2018;11:2077.
    1. Mann I, Sasikaran T, Sandler B, et al. Ablation versus anti-arrhythmic therapy for reducing all hospital episodes from recurrent atrial fibrillation (AVATAR-AF): Design and rationale. Am Heart J. 2019;214:36-45.

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