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Multicenter Study
. 2025 May 6;14(9):e039190.
doi: 10.1161/JAHA.124.039190. Epub 2025 Apr 16.

Same-Day Discharge After Catheter Ablation of Atrial Fibrillation in the United States

Amneet Sandhu  1   2 , Li Qin  3 , Karl Minges  3 , Sarah Zimmerman  3 , Ryan T Borne  4 , Vincenzo B Polsinelli  5 , P Michael Ho  2   5 , Jonathan C Hsu  6 , Sana M Al-Khatib  7 , James V Freeman  3 , Steven M Bradley  8 , Sunil V Rao  9 , Adrian F Hernandez  7 , Wendy S Tzou  1 , Paul D Varosy  1   2 , Paul L Hess  2   5
Affiliations
Multicenter Study

Same-Day Discharge After Catheter Ablation of Atrial Fibrillation in the United States

Amneet Sandhu et al. J Am Heart Assoc. .

Abstract

Background: Patients undergoing atrial fibrillation (AF) ablation have historically been hospitalized overnight or longer postprocedure. National rates of same-day discharge (SDD) following AF ablation remain unknown.

Methods and results: The NCDR (National Cardiovascular Data Registry) AF Ablation Registry was used to identify index procedures from January 1, 2016 to June 30, 2023. Patients were stratified by postprocedure disposition: (1) SDD, (2) overnight hospitalization (<1 day), or (3) >1 day hospitalization. Rates, clinical factors, and hospital-level variation associated with SDD were analyzed. Among 139 391 patients who underwent AF ablation across 197 hospitals, 51 622 (37.0%) underwent SDD, 78 220 (56.1%) were hospitalized overnight, and 9549 (6.9%) for >1 day postprocedure. SDD rates increased from 0.99% in Q1 2016 to 62.3% in Q2 2023 (P<0.0001), surpassing overnight hospitalization in Q1 of 2021. The likelihood of SDD increased significantly over time (odds ratio [OR], 1.26 per quarter-year [95% CI, 1.26-1.26]) with substantial variation across hospitals (median OR, 4.12 [95% CI, 3.48-4.79]). Those discharged the same day were less likely of Black race (OR, 0.71 [95% CI, 0.65-0.78]) and to have persistent AF (OR, 0.85 [95% CI, 0.82-0.88]) and cardiomyopathy (OR, 0.87 [95% CI, 0.84-0.91]). In total, major and overall complication rates were 0.70% and 2.13%, respectively. Major and overall complication rates were 0.03% and 0.19% for SDD and 0.24% and 0.98%, respectively, for overnight hospitalization.

Conclusions: Rates of SDD following AF ablation markedly increased over time, corresponding with onset of the COVID-19 pandemic, with substantial hospital variation. SDD patients had fewer comorbid conditions and were less likely to have persistent AF. Postprocedural complication rates with SDD were low and comparable with patients hospitalized overnight.

Keywords: atrial fibrillation; catheter ablation; same‐day discharge.

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Conflict of interest statement

Dr Sandhu is supported by VA Career Development Award HX003253 and American Heart Association Career Development Award 22CDA933316. Dr Hess is supported by VA Career Development Award HX002621 Merit Award 1I01HX003570‐01A2 from the Veteran's Affairs Health Systems Research. The remaining authors have no disclosures to report.

Figures

Figure 1
Figure 1. Patient and procedure‐related factors associated with SDD after AF ablation.
AF indicates atrial fibrillation; BMI, body mass index; CL, confidence limit; Ref, reference; and SDD, same‐day discharge.
Figure 2
Figure 2. Hospital‐level rates of SDD over the study period and display of hospital quartiles, stratified by rates of SDD.
SDD indicates same‐day discharge.
Figure 3
Figure 3. Rates of SDD, overnight hospitalization, and >1 day hospital stay after catheter ablation for AF.
AF indicates atrial fibrillation; and SDD, same‐day discharge.
See this image and copyright information in PMC

Comment in

References

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