Safety and feasibility of same-day discharge following catheter ablation of atrial fibrillation: what is known and what needs to be explored?

König, Sebastian; Richter, Sergio; Bollmann, Andreas; Hindricks, Gerhard

doi:10.1007/s00059-022-05102-0

Cited by 2 publications

(2 citation statements)

References 43 publications

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“…Our work corroborates and adds to previous findings regarding the non-inferiority of SDD compared to NSDD. 2,8,31,32 Using the propensity score model, we were able to compare AEs between groups in routine clinical practice. The weighted adjustments showed SDD was non-inferior to NSDD in terms of AEs.…”

Section: Discussionmentioning

confidence: 99%

Comprehensive analysis of same day discharge after atrial fibrillation ablation: Clinical, cost, and patient reported outcomes

Zenger,

Torre,

Zhang

et al. 2024

Cardiovasc electrophysiol

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BackgroundSame day discharge (SDD) following atrial fibrillation (AF) ablation procedure has emerged as routine practice, and primarily driven by operator discretion. However, the impacts of SDD on clinical outcomes, healthcare system costs, and patient reported outcomes (PROs) have not been systematically studied.MethodsWe retrospectively analyzed patients undergoing routine AF ablation procedures with SDD versus overnight observation (NSDD). After propensity adjustment we compared postprocedure adverse events (AEs), healthcare system costs, and changes in PROs.ResultsWe identified 310 cases, with 159 undergoing SDD and 151 staying at least one midnight in the hospital (NSDD). Compared with NSDD, SDD patients were similar age (mean 64 vs. 66, p = 0.3), sex (26% female vs. 27%, p = 0.8), and with lower mean CHADS2‐VA2Sc scores (2.0 vs. 2.7; p < 0.011). The primary outcome of AEs was noninferior in SDD versus NSDD patients (odds ratio 0.45, 95% confidence interval 0.21−0.99; noninferiority margin of 10%). There were also no differences in overall cost to the healthcare system between SDD and NSDD (p = 0.11). PROs numerically favored SDD (p = NS for all scores).ConclusionsPhysician selection for SDD appears at least as safe as NSDD with respect to clinical outcomes and SDD is not significantly less costly to the health system. There is a trend towards more favorable, general PROs among SDD patients. Routine SDD should be strongly considered for patients undergoing routine AF ablation procedures.

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Section: Discussionmentioning

confidence: 99%

Comprehensive analysis of same day discharge after atrial fibrillation ablation: Clinical, cost, and patient reported outcomes

Zenger,

Torre,

Zhang

et al. 2024

Cardiovasc electrophysiol

View full text Add to dashboard Cite

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“…Interestingly, those factors were not considered as eligibility criteria in the existing studies evaluating SDD following CA for AF. 6 In contrast, infrastructural aspects as well as the post-procedural caring at home were taken into account for patient selection at least in selected trials. 29 , 30 However, we only found a non-significant trend in univariable but not in multivariable analysis for the association of SDD perception and the distance between patients’ residence and an emergency medical facility.…”

Section: Discussionmentioning

confidence: 99%

Patient perspectives on same-day discharge following catheter ablation for atrial fibrillation: results from a patient survey as part of the monocentric FAST AFA trial

König,

Wohlrab,

Leiner

et al. 2023

Europace

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Introduction Same-day discharge (SDD) following catheter ablation (CA) of atrial fibrillation (AF) was already introduced in selected facilities in Europe but a widespread implementation has not yet succeeded. Data on patients’ perspectives is lacking. Therefore, we conducted a survey to address patients’ beliefs towards SDD and identify variables that are associated with their evaluation. Methods and results As part of the prospective, monocentric FAST AFA trial, patients aged ≥20 years undergoing left atrial CA for AF were asked to participate in the survey consisting of a study-specific questionnaire, the AF knowledge scale and pre-defined PROMs. The study cohort was stratified based on SDD willingness and a logistic regression analysis was used to identify predictors for patients’ valuation. Between 07/26/2021-07/01/2022, 256 of 376 screened patients consented to study participation of whom 248 (mean age 61.8 years, 33.9% female) completed the SDD survey. Of them, 50.0% were willing to have SDD concepts integrated into their clinical course with increased patient comfort (27.5%), shorter waiting times (14.6%) and a cost-efficient treatment (14.0%) being imaginable benefits. In contrast, expressed concerns included uncertainties with occurring complaints (50.6%), and the insufficient recognition (47.8%) and treatment (48.9%) of complications. EHRA class at baseline and inpatient treatments within the preceding year were predictors for SDD willingness whereas comorbidity burden or AF knowledge were not. Conclusion We provide a detailed survey expressing patients’ beliefs towards SDD following left atrial CA. Our findings may facilitate adequate patient selection to improve the future implementation of SDD programs in suitable cohorts.

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Safety and feasibility of same-day discharge following catheter ablation of atrial fibrillation: what is known and what needs to be explored?

Cited by 2 publications

References 43 publications

Comprehensive analysis of same day discharge after atrial fibrillation ablation: Clinical, cost, and patient reported outcomes

Comprehensive analysis of same day discharge after atrial fibrillation ablation: Clinical, cost, and patient reported outcomes

Patient perspectives on same-day discharge following catheter ablation for atrial fibrillation: results from a patient survey as part of the monocentric FAST AFA trial

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