OBJECTIVES: The purpose of this study was to evaluate the efficacy, health care utilization, and safety of a same-day discharge protocol. BACKGROUND: Catheter ablation of atrial fibrillation (AF) is the most common ablation performed. Increasing volumes of AF ablation are placing demands on hospital resources. In response, our institutions developed a same-day discharge protocol for AF ablation. METHODS: This was a multicenter cohort study of all patients undergoing AF ablation from 2010 to 2014 at 2 major centers. The primary efficacy outcome was the proportion of successful same-day discharges. The primary health care utilization outcome was 30-day hospital readmission for any reason. The primary safety outcome was a composite of 30-day death, stroke/transient ischemic attack or embolism, or bleeding requiring hospitalization. RESULTS: A total of 3,054 patients underwent AF ablation from 2010 to 2014 and met inclusion criteria. Same-day discharge was achieved in 79.2% (2,418 of 3,054). Hospital readmission at 30 days was 7.7% for the same-day discharge group, 10.2% for those who remained in the hospital overnight without complications (p = 0.055 for comparison with same-day discharge), and 19.5% (p < 0.001) for those who remained in the hospital with procedural complications (7.7%). Complication rates from discharge to 30 days (excluding immediate procedural complications) were 0.37% for the same-day discharge group, 0.36% (p = 0.999) for those kept overnight without complications, and 2.5% (p = 0.044) for those with initial procedural complications. CONCLUSIONS: Same-day discharge after AF ablation is feasible in the majority of patients with use of a standardized protocol. This approach was not associated with higher hospital readmission or complication rates after discharge.
OBJECTIVES: The purpose of this study was to evaluate the efficacy, health care utilization, and safety of a same-day discharge protocol. BACKGROUND: Catheter ablation of atrial fibrillation (AF) is the most common ablation performed. Increasing volumes of AF ablation are placing demands on hospital resources. In response, our institutions developed a same-day discharge protocol for AF ablation. METHODS: This was a multicenter cohort study of all patients undergoing AF ablation from 2010 to 2014 at 2 major centers. The primary efficacy outcome was the proportion of successful same-day discharges. The primary health care utilization outcome was 30-day hospital readmission for any reason. The primary safety outcome was a composite of 30-day death, stroke/transient ischemic attack or embolism, or bleeding requiring hospitalization. RESULTS: A total of 3,054 patients underwent AF ablation from 2010 to 2014 and met inclusion criteria. Same-day discharge was achieved in 79.2% (2,418 of 3,054). Hospital readmission at 30 days was 7.7% for the same-day discharge group, 10.2% for those who remained in the hospital overnight without complications (p = 0.055 for comparison with same-day discharge), and 19.5% (p < 0.001) for those who remained in the hospital with procedural complications (7.7%). Complication rates from discharge to 30 days (excluding immediate procedural complications) were 0.37% for the same-day discharge group, 0.36% (p = 0.999) for those kept overnight without complications, and 2.5% (p = 0.044) for those with initial procedural complications. CONCLUSIONS: Same-day discharge after AF ablation is feasible in the majority of patients with use of a standardized protocol. This approach was not associated with higher hospital readmission or complication rates after discharge.
Authors: Benjamin A Steinberg; Shannon Woolley; Haojia Li; Candice Crawford; Christopher A Groh; Leenhapong Navaravong; Ravi Ranjan; Brian Zenger; Yue Zhang; T Jared Bunch Journal: J Cardiovasc Electrophysiol Date: 2022-05-30 Impact factor: 2.942
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
Authors: Victoria L Bartlett; Joseph S Ross; Nilay D Shah; Laura Ciaccio; Joseph G Akar; Peter A Noseworthy; Sanket S Dhruva Journal: Cardiovasc Digit Health J Date: 2021-07-03