Evaluating outcomes of same-day discharge after catheter ablation for atrial fibrillation in a real-world cohort

Abstract

Background: As same-day discharge (SDD) after catheter ablation (CA) for atrial fibrillation (AF) is increasingly utilized, it is important to further investigate this approach. Objective: To investigate the safety and efficacy of SDD after CA for AF in a large nationwide administrative sample. Methods: The IBM MarketScan Commercial Claims and Encounters database was used to identify adult patients under 65 years undergoing CA for AF (2016–2020). Eligible patients were indexed to date of first CA and classified into SDD or overnight stay (ONS) groups based on length of service. A 1:3 propensity score matching was used to create comparable SDD:ONS samples. Study outcomes were CA-related complications within 30 days after index procedure and AF recurrence within 1 year. Cox proportional hazards models were estimated for outcome comparison. Results: In the postmatch 30-day cohort, there were 1610 SDD and 4637 ONS patients with mean age 56.1 (± 7.6) years. There was no significant difference in composite 30-day postprocedural complication rate between SDD and ONS groups (2.7% vs 2.8%, respectively; P = .884). The most common complications were cerebrovascular events (0.7% vs 0.7%; P = .948), vascular access events (0.6% vs 0.6%; P = .935), and pericardial complications (0.6% vs 0.5%; P = .921). Further, no significant difference in composite AF recurrence rate at 1 year was observed among SDD and ONS groups (10.2% vs 8.8%; hazard ratio = 1.167; 95% confidence interval 0.935–1.455; P = .172). Conclusion: In a large, propensity-matched, real-world sample, SDD appears to be safe and have similar outcomes compared with overnight observation following CA for AF.

Keywords

• Atrial fibrillation
• Catheter ablation
• Efficacy
• Safety
• Same-day discharge