Same day discharge after AF ablation not tied to complications: Study

With the use of a standardized protocol, patients who underwent Ablation for Atrial Fibrillation can be discharged on the same day, finds a study. The study was published in the Journal of the American College of Cardiology: Clinical Electrophysiology, 2020.

Catheter ablation is the most common ablation procedure performed for atrial fibrillation (AF). Increasing number of AF ablation are posing challenges on hospital resources. Researchers from the British Columbia developed a same-day discharge protocol for AF ablation and evaluated the efficacy, health care utilization, and safety of a same-day discharge protocol.

The study was a multi-center cohort of 3054 patients undergoing AF ablation from 2010 to 2014 at 2 major centers. Participants were selected based of set of inclusion criteria. The primary efficacy outcome was the proportion of successful same-day discharges and the primary health care utilization outcome was 30-day hospital readmission for any reason. They also measured the primary safety outcome which was a composite of 30-day death, stroke/transient ischemic attack or embolism, or bleeding requiring hospitalization.

The findings of the study were:

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.

The team state:, "This study demonstrates that the vast majority of complications are identified during or immediately after the procedure, with a composite serious complication rate of 0.43% after discharge in the entire cohort, and only 0.37% in those discharged on the same-day.

The researchers thus concluded that 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. 

For further reading, click the following link: https://doi.org/10.1016/j.jacep.2020.02.009