Same-day cardiac catheter ablation is safe and cost-effective: Experience from a UK tertiary center

Theodoreson, Mark D; Chohan, Bhaveek C.; McAloon, Christopher; Sandhu, Amritpal; Lancaster, Christopher J.; Yusuf, Salim; Foster, W. Michael; Osman, Faizel

doi:10.1016/j.hrthm.2015.05.006

Cited by 26 publications

(21 citation statements)

References 9 publications

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“…Largely, these findings reflect the shifting trends toward the outpatient performance of the procedure. With evolving technology and institutional experience, safety and efficacy of the procedure has risen tremendously in recent years, as noted by previously published studies . Furthermore, due to improved efficacy, need of repeated procedure to achieve the success has declined, which partly explains the declining frequency of the in‐hospital AF ablation procedure.…”

Section: Discussionmentioning

confidence: 98%

“…With evolving technology and institutional experience, safety and efficacy of the procedure has risen tremendously in recent years, as noted by previously published studies. 24,26 Furthermore, due to improved efficacy, need of repeated procedure to achieve the success has declined, which partly explains the declining frequency of the in-hospital AF ablation procedure. Our estimated numbers cannot account for procedures that are performed as outpatient for observation.…”

Section: Discussionmentioning

confidence: 99%

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Temporal trends of in‐hospital complications associated with catheter ablation of atrial fibrillation in the United States: An update from Nationwide Inpatient Sample database (2011–2014)

Tripathi

Arora

Kumar

et al. 2018

Cardiovasc electrophysiol

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Temporal trends of in‐hospital complications associated with catheter ablation of atrial fibrillation in the United States: An update from Nationwide Inpatient Sample database (2011–2014)

Tripathi

Arora

Kumar

et al. 2018

Cardiovasc electrophysiol

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“…We previously reported standard same-day ablation was safe/cost-effective [ 6 ]; applying the same principles to complex left-atrial ablation could have significant benefits. Opel et al [ 8 ] demonstrated safe and successful same-day AF cryo-ablation.…”

Section: Discussionmentioning

confidence: 99%

“…Overnight-stay has higher costs compared with same-day procedures. Studies evaluating same-day catheter ablation for AF [ 2 , 3 ] and catheter ablation more widely [ 4 ] have suggested same-day ablation is safe, effective [ 5 ] and has significant cost-savings for healthcare providers [ [6] , [7] , [8] ]. Same-day ablations may benefit patients/healthcare providers by reducing logistic constraints on hospital resources, especially in the current financial climate and Covid-19 pandemic, the latter making overnight hospital-stay challenging.…”

Section: Introductionmentioning

confidence: 99%

“…Same-day ablations may benefit patients/healthcare providers by reducing logistic constraints on hospital resources, especially in the current financial climate and Covid-19 pandemic, the latter making overnight hospital-stay challenging. We previously reported same-day standard catheter ablation was safe and cost-effective [ 6 ] but data on complex left-atrial ablation are limited. We started performing same-day complex left-atrial ablations in 2016 and wanted to evaluate the safety and efficacy of this policy.…”

Section: Introductionmentioning

confidence: 99%

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Safety and cost-effectiveness of same-day complex left atrial ablation

Datla

Weight

et al. 2021

International Journal of Cardiology

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Background Catheter ablation for complex left-atrial arrhythmia is increasing worldwide with many centres admitting patients overnight. Same-day procedures using conscious sedation carry significant benefits to patients/healthcare providers but data are limited. We evaluated the safety and cost-effectiveness of same-day complex left-atrial arrhythmia ablation. Method Multi-centre retrospective cohort study of all consecutive complex elective left-atrial ablation procedures performed between January 2011 and December 2019. Data were collected on planned same-day discharge versus overnight stay, baseline parameters, procedure details/success, ablation technology, post-operative complications, unplanned overnight admissions/outcomes at 4-months and mortality up to April 2020. A cost analysis of potential savings was also performed. Results A total of 967 consecutive patients underwent complex left-ablation using radiofrequency (point-by-point ablation aided by 3D-mapping or PVAC catheter ablation with fluoroscopic screening) or cryoballoon-ablation (mean age: 60.9 ± 11.6 years, range 23-83 yrs., 572 [59%] females). The majority of patients had isolation of pulmonary veins alone ( n = 846, 87%) and most using conscious-sedation alone ( n = 921, 95%). Of the total cohort, 414 (43%) had planned same-day procedure with 35 (8%) admitted overnight due to major ( n = 5) or minor ( n = 30) complications. Overall acute procedural success-rate was 96% ( n = 932). Complications in planned overnight-stay/same-day cohorts were low. At 4-month follow-up there were 62 (6.4%) readmissions (femoral haematomas, palpitation, other reasons); there were 3 deaths at mean follow-up of 42.0 ± 27.6 months, none related to the procedure. Overnight stay costs £350; the same-day ablation policy over this period would have saved £310,450. Conclusions Same-day complex left-atrial catheter ablation using conscious sedation is safe and cost-effective with significant benefits for patients and healthcare providers. This is especially important in the current financial climate and Covid-19 pandemic.

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Efficacy and safety of same‐day discharge after atrial fibrillation ablation: A systematic review and meta‐analysis

Rashedi

Tavolinejad

Kazemian

et al. 2022

Clinical Cardiology

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Conventionally, patients have been admitted overnight after atrial fibrillation (AF) catheter ablation. Several centers have recently adopted a same-day discharge (SDD) protocol for patients undergoing AF catheter ablation. We aimed to systematically review the current evidence for the safety and efficacy of SDD after AF catheter ablation. A systematic search was performed in PubMed, Embase, Scopus, Web of Science, and the Cochrane library until August 21, 2021. The risk of bias was assessed with the "Methodological Index for Non-Randomized Studies" (MINORS).The pooled efficacy rate of SDD protocol (defined as the proportion of patients discharged the same day of ablation among the patients who were planned for SDD) was calculated. Meanwhile, pooled major complication rates and early readmission or emergency department (ED) visit rates were evaluated in successful and planned SDD groups separately. Overall, 12 observational studies consisting of 18,065 catheter ablations were included, among which 7320 (40.52%) were discharged the same-day after ablation. The pooled efficacy was 90.3% (95% confidence interval ). The major complication rates were 1.1% (95%CI [0.5-1.9]), and 0.7% (95% CI [0.0-3.1]) in planned SDD and successful SDD groups, respectively.In addition, readmission/ED visit rate were 3.0% (95%CI [0.9-6.1]), and 3.1% (95% CI [0.8-6.5]) in the same groups. There were no significant differences between planned SDD and overnight groups with respect to major complication rate (risk ratio = 0.70, 95%CI [0.35-1.42], p-value = .369). The available data indicates that SDD after AF ablation is safe and efficient. Further prospective and randomized studies are warranted to elucidate the safety of SDD after AF ablation and develop a standardized SDD protocol.

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Same-day cardiac catheter ablation is safe and cost-effective: Experience from a UK tertiary center

Cited by 26 publications

References 9 publications

Temporal trends of in‐hospital complications associated with catheter ablation of atrial fibrillation in the United States: An update from Nationwide Inpatient Sample database (2011–2014)

Temporal trends of in‐hospital complications associated with catheter ablation of atrial fibrillation in the United States: An update from Nationwide Inpatient Sample database (2011–2014)

Safety and cost-effectiveness of same-day complex left atrial ablation

Efficacy and safety of same‐day discharge after atrial fibrillation ablation: A systematic review and meta‐analysis

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