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

Creta, A; Ventrella, N; Providência, R; Earley, MJ; Sporton, S; Dhillon, G; Papageorgiou, N; ... Hunter, RJ; + view all (2020) Same-day discharge following catheter ablation of atrial fibrillation: A safe and cost-effective approach. Journal of Cardiovascular Electrophysiology 10.1111/jce.14789. (In press).

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Abstract

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 center and in a district general hospital, and identified those discharged on the same day of treatment. The safety endpoint was any complication and/or presentation to hospital in the 48‐h and at 30 days postdischarge. 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. 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 at 48‐h, however only 0.7% (5) required at least 1 day of hospitalization. Bleeding or hematoma 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‐h postdischarge. Overall rate of complication and/or presentation to hospital at 30 days was 3.7%. Our day‐case policy resulted in an annual cost‐saving of approximately of £83 927 for our hospital. 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.

Type: Article
Title: Same-day discharge following catheter ablation of atrial fibrillation: A safe and cost-effective approach
Location: United States
DOI: 10.1111/jce.14789
Publisher version: https://doi.org/10.1111/jce.14789
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: catheter ablation of atrial fibrillation, cost, day case, nurse led discharge, same-day discharge
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science > Clinical Science
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Health Informatics
URI: https://discovery.ucl.ac.uk/id/eprint/10115582
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