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Same-day discharge after catheter ablation for routine arrhythmias: an initial experience
P Golia1, A Bandini, M Galvani
1Division of Cardiology Morgagni-Pierantoni Hospital, Forlì, Italy. p.golia@hotmail.it
Insights
Same-day discharge after catheter ablation (CA) is feasible and safe for selected patients with routine arrhythmias. This approach offers organizational benefits and improves patient experience.
Area of Science:
- Cardiology
- Electrophysiology
Background:
- Same-day discharge (SDD) following catheter ablation (CA) is not a widely adopted practice.
- Evaluating the feasibility and safety of SDD in a selected patient cohort undergoing CA is crucial.
Purpose of the Study:
- To assess the feasibility and safety of same-day discharge (SDD) after catheter ablation (CA) in a selected group of patients.
- To determine the potential impact of SDD on clinical practice and patient well-being.
Main Methods:
- 401 CA procedures in 379 patients were reviewed.
- Exclusion criteria included ventricular arrhythmias, atrial fibrillation, atypical atrial flutter, AV node ablation, arterial/transseptal access, and clinical/organizational factors.
- Eligibility for SDD was determined based on these criteria.
Main Results:
- 223 patients (56%) were discharged on the same day: 114 for atrial flutter (AFL) and 109 for supraventricular tachycardia.
- Exclusion due to facility limitations decreased significantly from 2008 to 2009 (45 vs. 2).
- In 2009, 68% of CA procedures resulted in SDD. Three groin hematomas occurred, all in AFL patients.
Conclusions:
- Same-day discharge (SDD) is a safe and feasible option for most patients undergoing catheter ablation (CA) for routine arrhythmias.
- Implementing SDD can lead to significant organizational improvements and enhance patient satisfaction.
- This strategy holds potential for widespread adoption in daily clinical practice.
Aim:
Same-day discharge (SDD) in the setting of catheter ablation (CA) is not widely applied. We present our experience concerning SDD in a selected population of patients who underwent CA; the outcome was evaluated in terms of feasibility and safety.
Methods:
401 CA procedures were performed at our institution between January 2008 and December 2009 in 379 patients (65±16 years, 221 men). 336 CA procedures (84%) were considered eligible for SDD, after the exclusion of ventricular arrhythmias, atrial fibrillation, atypical atrial flutter, AV node ablation as well as procedures involving an arterial or transseptal access. Subsequently, a number of clinical and organizational exclusion criteria were applied.
Results:
223 patients were actually discharged on the same day of CA (56% of 401 overall CA procedures): 114 atrial flutter (AFL) and 109 supraventricular tachycardia. Many patients were excluded before CA due to a limited availability of the day-hospital facility; this occurred more frequently in the year 2008 than 2009 (45 vs. 2, P=0.0001); in the year 2009 the rate of total CA procedures which underwent SDD was of 68%. Overall, three groin hematomas occurred, all in patients ablated for AFL. Two of them were recognized during the postablation
Conclusion:
SDD can be safely performed in most patients undergoing CA for routine arrhythmias. This may result in a significant impact on daily practice in terms of both organizational improvement and subjective benefit for the patients.
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