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. 2023 Feb 16;25(2):400-407.
doi: 10.1093/europace/euac170.

Same-day discharge for atrial fibrillation ablation: outcomes and impact of ablation modality

Marc W Deyell  1   2 , Kurt Hoskin  1 , Jacqueline Forman  3 , Zachary W Laksman  1   2 , Nathaniel M Hawkins  1   2 , Matthew T Bennett  1   2 , John A Yeung-Lai-Wah  1 , Santabhanu Chakrabarti  1 , Andrew D Krahn  1   2 , Jason G Andrade  1   2
Affiliations

Same-day discharge for atrial fibrillation ablation: outcomes and impact of ablation modality

Marc W Deyell et al. Europace. .

Abstract

Aims: Same-day discharge is increasingly common after catheter ablation for atrial fibrillation (AF). However, the impact of same-day discharge on healthcare utilization after ablation and whether this differs by ablation modality remains uncertain. We examined the safety, efficacy, and subsequent healthcare utilization of a same-day discharge protocol for AF ablation, including radiofrequency (RF) and cryoballoon ablation, in a contemporary cohort.

Methods and results: All consecutive patients for whom full healthcare utilization data were available at two centres and who underwent AF ablation from 2018 to 2019 were included. Same-day discharge was the default strategy for all patients. The efficacy and safety outcomes were proportions of same-day discharge and readmission/emergency room (ER) visits, and post-discharge complications, respectively. Of the 421 patients who underwent AF ablation (mean 63.3 ± 10.2 years, 33% female), 90.5% (381/421) achieved same-day discharge with no difference between RF and cryoballoon ablation (89.8 vs. 95.1%, adjusted P = 0.327). Readmission ≤30 days occurred in 4.8%, with ER visits ≤30 days seen in 26.1% with no difference between ablation modalities (P = 0.634). Patients admitted overnight were more likely to present to the ER (40.0 vs. 24.7% with same-day discharge, P = 0.036). The overall post-discharge complication rate was low at 4/421 (1.0%), with no difference between ablation modality (P = 0.324) and admission/same-day discharge (P = 0.485).

Conclusion: Same-day discharge can be achieved in a majority of patients undergoing RF or cryoballoon ablation for AF. Healthcare utilization, particularly ER visits, remains high after AF ablation, regardless of ablation modality or same-day discharge.

Keywords: Atrial fibrillation; Catheter ablation; Cryotherapy; Outcomes; Radiofrequency.

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Conflict of interest statement

Conflict of interest: M.W.D. reports honoraria and research funding from Biosense Webster, and honoraria from Medtronic, Abbott, and Boston Scientific. J.G.A. reports research funding and honoraria from Medtronic.

Figures

Graphical Abstract
Graphical Abstract
Figure 1
Figure 1
Timing of ER visits and rehospitalization. The graph shows the timing of any readmission to hospital or ER visit after discharge and up to 30 days. ER, emergency room.
Figure 2
Figure 2
Hospital readmission and ER visits by ablation modality and by same-day discharge. The rates of rehospitalization and ER visits are presented by ablation modality, and whether the patient was discharged on the same-day or kept overnight after ablation. Abbreviation as in Figure1.
See this image and copyright information in PMC

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