INTRODUCTION: Pulmonary vein isolation (PVI) has become the standard treatment of symptomatic atrial fibrillation. Patients remain hospitalized for at least 24 hours to detect potential complications in most centers worldwide. There is still a lack of data about the safety of same-day discharge. OBJECTIVES: The aim was to compare the safety of same-day discharge with next day discharge after overnight monitoring.The rate of new hospitalization and visits to the emergency department and the costeffectiveness of the same-day discharge approach were evaluated. METHODS: We conducted a longitudinal and prospective cohort study of all the consecutive patients undergoing scheduled pulmonary vein ablation of either paroxysmal or persistent atrial fibrillation (AF). The complications were recorded by type and time of occurrence. RESULTS: Overall 58 patients were discharged within the same day and 137 patients stayed overnight after PVI. There were no significant differences in demography, comorbidities and other predictors of complications. No complications were reported after the sixth hour. We observed a significant difference in the number of visits to emergency department: 15.5% for the same-day discharge group vs. 30.7% for the overnight hospitalization group (p 0.03). Only 50% of the reasons to visit the emergency department were cardiovascular causes. No cases of pericardial tamponade were reported and none of the patients required new hospitalization up to 30 days of follow up. CONCLUSIONS: Same-day discharge after PVI is feasible and cost-effective. This is the first study analyzing the experience in patients undergoing AVP,considering acare based component to this procedure. This approach would provide significant benefits for patients and health care providers.
INTRODUCTION: Pulmonary vein isolation (PVI) has become the standard treatment of symptomatic atrial fibrillation. Patients remain hospitalized for at least 24 hours to detect potential complications in most centers worldwide. There is still a lack of data about the safety of same-day discharge. OBJECTIVES: The aim was to compare the safety of same-day discharge with next day discharge after overnight monitoring.The rate of new hospitalization and visits to the emergency department and the costeffectiveness of the same-day discharge approach were evaluated. METHODS: We conducted a longitudinal and prospective cohort study of all the consecutive patients undergoing scheduled pulmonary vein ablation of either paroxysmal or persistent atrial fibrillation (AF). The complications were recorded by type and time of occurrence. RESULTS: Overall 58 patients were discharged within the same day and 137 patients stayed overnight after PVI. There were no significant differences in demography, comorbidities and other predictors of complications. No complications were reported after the sixth hour. We observed a significant difference in the number of visits to emergency department: 15.5% for the same-day discharge group vs. 30.7% for the overnight hospitalization group (p 0.03). Only 50% of the reasons to visit the emergency department were cardiovascular causes. No cases of pericardial tamponade were reported and none of the patients required new hospitalization up to 30 days of follow up. CONCLUSIONS: Same-day discharge after PVI is feasible and cost-effective. This is the first study analyzing the experience in patients undergoing AVP,considering acare based component to this procedure. This approach would provide significant benefits for patients and health care providers.
Authors: Fatih Bayrak; Gian-Battista Chierchia; Mehdi Namdar; Yoshinao Yazaki; Andrea Sarkozy; Carlo de Asmundis; Stephan Andreas Muller-Burri; Jayakeerthi Rao; Danilo Ricciardi; Antonio Sorgente; Pedro Brugada Journal: Europace Date: 2011-11-23 Impact factor: 5.214
Authors: Mark D Theodoreson; Bhaveek C Chohan; Christopher J McAloon; Amritpal Sandhu; Christopher J Lancaster; Shamil Yusuf; William Foster; Faizel Osman Journal: Heart Rhythm Date: 2015-05-09 Impact factor: 6.343
Authors: Eltigani Abdelaal; Sunil V Rao; Ian C Gilchrist; Ivo Bernat; Adhir Shroff; Ronald Caputo; Olivier Costerousse; Samir B Pancholy; Olivier F Bertrand Journal: JACC Cardiovasc Interv Date: 2013-01-23 Impact factor: 11.195
Authors: Emily N Guhl; Donald Siddoway; Evan Adelstein; Raveen Bazaz; George S Mendenhall; Jan Nemec; Samir Saba; David Schwartzman; Andrew Voigt; Norman C Wang; Sandeep K Jain Journal: J Am Heart Assoc Date: 2016-07-21 Impact factor: 5.501
Authors: Matthew T Brown; Mary M Pelling; Soroosh Kiani; Faisal M Merchant; Mikhael F El-Chami; Angel R Leon; Stacy Westerman; Anand Shah; Donna Wise; Michael S Lloyd Journal: J Atr Fibrillation Date: 2021-02-28