Introduction:
We evaluated the safety of same-day discharge in patients undergoing atrial fibrillation ablation procedure.
Methods:
A systematic search was conducted on 05/05/2020 by 2 independent researchers in MEDLINE, EMBASE and other databases for studies comparing the safety of same-day discharge versus overnight stay for patients undergoing atrial fibrillation ablation. No randomized controlled trials met the inclusion criteria, so observational studies were included in the analysis. Mantel-Haenszel risk ratios (random effects model) were calculated and for heterogeneity I
2
statistics were reported.
Results:
A total of 5 observational studies with 5018 patients were included. There was a non-statistically significant trend towards repeat 30 day hospital visits associated with same-day discharge as compared with overnight stay (RR=1.92, CI 0.44-8.32, p=0.39) (Figure-1). There were no differences between same-day discharge vs overnight stay in other outcomes including vascular complications (RR=1.24, CI 0.48-3.23), cardiac tamponade (RR=1.01, CI 0.15-6.60), stroke/transient ischemic attack/thromboembolic complications (RR=0.88, CI 0.05-16.19) and mortality (RR=1.03, CI 0.05=19.36) (Figure-1).
Conclusion:
Same day discharge after atrial fibrillation ablation is safe and has the potential to be a cost-effective strategy. Randomized trials are needed to validate these results.
Figure-1: Forest plot of outcomes with same-day discharge vs overnight stay for patients undergoing atrial fibrillation ablation.
IMPROVING PATIENTS' EXPERIENCE OF SAME-DAY DISCHARGE AFTER ATRIAL FIBRILLATION ABLATION
