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15/Same-day discharge following catheter ablation of atrial fibrillation: a safe and cost-effective approach

Published Online: September 27th 2010 European Journal of Arrhythmia & Electrophysiology. 2020;6(Suppl. 1):abstr15
Authors: A Creta (Presenting Author) - Barts Heart Centre, London; N Ventrella - Campus Bio-Medico University, Rome; R Providencia - Barts Heart Centre, London; MJ Earley - Barts Heart Centre, London; S Sporton - Barts Heart Centre, London; AW Chow - Barts Heart Centre, London; PD Lambiase - Barts Heart Centre, London; M Lowe - Barts Heart Centre, London; RJ Schilling - Barts Heart Centre, London; M Finlay - Barts Heart Centre, London; RJ Hunter - Barts Heart Centre, London
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Introduction: The frequency of catheter ablation for atrial fibrillation (AF) has increased dramatically, stretching resources. Discharge on the same day as treatment may increase the efficiency and throughput. There are limited data regarding the safety of this strategy.

Methods: We performed a retrospective analysis of consecutive patients undergoing AF ablation in a tertiary centre and in a district general hospital, and identified those discharged on the same day of treatment. The safety endpoint was any major complication and/or presentation to hospital in the 48-hours post discharge. We performed an economic analysis to calculate potential cost saving.

Results: Among a total population of 2628 patients, we identified 727 subjects (61.1±12.5 years, 69.6% male) undergoing day-case AF ablation. Most of them suffered from paroxysmal AF (58%) and underwent a de novo procedure (86.1%). Cryoballoon technique was used in 79.2% of the day-cases, and 91.6% of the procedures were performed under conscious sedation. 1.8% (13) of the participants met the safety composite endpoint, however only 0.7% (5) required at least one day of hospitalisation. Bleeding/haematoma at the femoral access site (0.5%) and pericarditic chest pain (0.5%) were the main reasons for readmission. None experienced cardiac tamponade or other life-threatening complications in the 48-hours post-discharge. Our day-case policy resulted in a cost-saving of approximately £287,422 for our hospital (average of £83,927 annually).

Conclusion: In this large multicentre cohort, same-day discharge in selected patients following AF ablation appears to be safe and cost-effective, with a very low rate of early readmission or post-discharge complication.

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