Comparison between same‐day discharge and overnight stay after atrial fibrillation ablation: systematic review and meta‐analysis

2021 ◽  
Author(s):  
Narut Prasitlumkum ◽  
Wisit Cheungpasitporn ◽  
Ronpichai Chokesuwattanaskul ◽  
Jakrin Kewcharoen ◽  
Nithi Tokavanich ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Systematic Review ◽  
Meta Analysis ◽  
Atrial Fibrillation Ablation ◽  
Overnight Stay ◽  
Same Day Discharge

Abstract 13720: Safety of Same-day Discharge for Atrial Fibrillation Ablation: A Systematic Review and Meta-analysis

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Khawaja H Akhtar ◽  
Khadija N Sami ◽  
Muhammad H Khan ◽  
Ali H Jafry ◽  
Amna M Chaudhary ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Observational Studies ◽  
Meta Analysis ◽  
Vascular Complications ◽  
Cost Effective ◽  
Atrial Fibrillation Ablation ◽  
Forest Plot ◽  
Overnight Stay ◽  
Same Day Discharge ◽  
Ischemic Attack

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.

scholarly journals OUTCOMES OF ATRIAL FIBRILLATION ABLATION IN PATIENTS WITH HYPERTROPHIC CARDIOMYOPATHY: A SYSTEMATIC REVIEW AND META-ANALYSIS

2020 ◽  
Vol 75 (11) ◽  
pp. 399
Author(s):  
Jorge Penalver ◽  
Veraprapas Kittipibul ◽  
Amanda Fernandes ◽  
Gilson Fernandes ◽  
Michael Dyal
Keyword(s):  
Atrial Fibrillation ◽  
Systematic Review ◽  
Hypertrophic Cardiomyopathy ◽  
Meta Analysis ◽  
Atrial Fibrillation Ablation

Role of adjunctive posterior wall isolation in patients undergoing atrial fibrillation ablation: a systematic review and meta-analysis

2019 ◽  
Vol 58 (1) ◽  
pp. 77-86 ◽  
Author(s):  
Florentino Lupercio ◽  
Andrew Y. Lin ◽  
Omar M. Aldaas ◽  
Jorge Romero ◽  
David Briceno ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Systematic Review ◽  
Meta Analysis ◽  
Posterior Wall ◽  
Atrial Fibrillation Ablation

scholarly journals THE EFFICACY OF POSTERIOR WALL ISOLATION IN ATRIAL FIBRILLATION ABLATION: A SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS

2021 ◽  
Vol 77 (18) ◽  
pp. 307
Author(s):  
Chanavuth Kanitsoraphan ◽  
Pattara Rattanawong ◽  
Jakrin Kewcharoen ◽  
Chol Techorueangwiwat ◽  
Raktham Mekritthikrai ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Systematic Review ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Posterior Wall ◽  
Atrial Fibrillation Ablation ◽  
Controlled Trials ◽  
Randomized Controlled

P469Minimally interrupted versus uninterrupted non-vitamin K anticoagulants for atrial fibrillation ablation. a meta-analysis of randomized controlled trials

EP Europace ◽  
2020 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
B Enache ◽  
H Del Castillo-Carnevali ◽  
O Lairez ◽  
M Postula
Keyword(s):  
Atrial Fibrillation ◽  
Systematic Review ◽  
Randomized Controlled Trials ◽  
Primary Outcome ◽  
Meta Analysis ◽  
Atrial Fibrillation Ablation ◽  
Controlled Trials ◽  
Minor Bleeding ◽  
Af Ablation ◽  
Randomized Controlled

Abstract Introduction More and more patients undergoing atrial fibrillation (AF) ablation are anticoagulated with direct oral anticoagulants (DOAC). In order to balance the peri-procedural risk of bleeding with the risk of stroke, an important clinical question is whether to continue an interrupted DOAC administration or minimal interrupt by skipping the last one or two doses before the procedure. Dealing with rare events, the randomized controlled trials (RCTs) looking at this question have not been sufficiently powered to give a definitive answer.  Purpose To do a systematic review of the literature comparing an uninterrupted DOAC strategy to minimally interrupted (1-2 doses) strategy in the setting of AF ablation in terms of peri-procedural stroke and bleeding. Methods PubMed, EMBASE, and Cochrane databases were searched for RCTs comparing a strategy of uninterrupted versus minimally interrupted DOAC administration for atrial fibrillation ablation. The primary endpoint was a composite of clinically significant adverse events: ischemic stroke, transient ischemic attack (TIA), systemic embolism, and major or minor bleeding events. A random-effects meta-analysis was performed on the resulting trials. The systematic review protocol was pre-registered in the PROSPERO database. The study selection process followed the PRISMA statement. Results After checking and removing duplicates, 188 articles were screened by reading the title and abstract. 8 of them were selected for a full text screening.  Because 3 were not randomized, finally, 5 RCTs met the inclusion criteria. A total of 1 769 patients were included in the meta-analysis, and the sample size of the individual RCTs ranged from 97 to 846 patients. The overall prevalence of paroxysmal AF varied from 54% to 100%. The mean age of patients ranged from 63,5 to 70 years, and 21,6% to 32,8% of the trial populations were women. Comorbidities, such as hypertension, dyslipidemia, and diabetes, were common. Most patients had CHA2DS2-VASc < 3; range from 1,7 to 2,7We found consistently low rates of strokes, TIAs, systemic embolisms and bleedings across all trials and both arms (RR = 0.98, 95% CI 0.69 – 1.38, I-squared = 0%, p = 0.874).  Conclusion We found no evidence in favor of a difference between uninterrupted and interrupted administration of NOACs regarding the primary outcome of clinical thromboembolic and bleeding. Abstract Figure. Meta-analysis of the primary outcome

scholarly journals Prevalence and prevention of oesophageal injury during atrial fibrillation ablation: a systematic review and meta-analysis

EP Europace ◽  
2018 ◽  
Vol 21 (1) ◽  
pp. 80-90 ◽  
Author(s):  
Francis J Ha ◽  
Hui-Chen Han ◽  
Prashanthan Sanders ◽  
Andrew W Teh ◽  
David O'Donnell ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Systematic Review ◽  
Meta Analysis ◽  
Atrial Fibrillation Ablation ◽  
Oesophageal Injury

scholarly journals Same-day discharge vs hospital admission after cardiac device implantations: a systematic review and meta-analysis

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
A Trongtorsak ◽  
J Kewcharoen ◽  
S Thangjui ◽  
P Worapongsatitaya ◽  
R Yodsuwan ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Cardiac Device ◽  
Funding Sources ◽  
Overnight Stay ◽  
Same Day Discharge ◽  
Retrospective Cohort Studies ◽  
Feasible Alternative ◽  
Randomized Control ◽  
The Cost

Abstract Background Due to the increasing need for cardiac device implantations, the cost of healthcare has been rising. This includes the cost of hospital stay after the procedure. Thus, we conducted this systematic review and meta-analysis to assess the safety and feasibility of same-day discharge (SDD) after cardiac device implantations. Methods We searched MEDLINE, and Embase databases from inception to March 2021 to identify studies that compared clinical outcomes between SDD group and hospital overnight stay (HO) group after cardiac device implantations. Outcomes included complications after the procedure, mortality, and rehospitalization. Data from each study were combined using the random-effects model to calculate pooled odds ratio (OR) with 95% confidence interval (CI). Results Six studies (1 randomized control trial, 1 prospective cohort study and 4 retrospective cohort studies) with a total of 59,312 patients were included. SDD was not associated with more procedure-related complications. The pooled ORs for wound problems, pneumothorax, hematoma, and lead dislodgement/repositioning were 0.86 (95% CI: 0.2–3.68, p=0.834), 1.36 (95% CI: 0.26–7.12, p=0.718), 0.35 (95% CI: 0.01–9.85, p=0.534), and 1.71 (95% CI: 0.64–4.54, p=0.281) respectively. Readmission rate (pooled OR= 1.38, 95% CI: 0.51–3.69, p=0.524) and mortality rate (pooled OR= 0.86, 95% CI: 0.62–1.2, p=0.383) were similar between both groups. As shown in figure 1. Conclusions Our meta-analysis suggested that same-day discharge after cardiac device implantations is a safe and feasible alternative to a hospital overnight stay strategy. FUNDunding Acknowledgement Type of funding sources: None.

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