Related Experiment Video
Updated: Jul 31, 2025
Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
Same-day discharge for left atrial appendage occlusion procedure: A systematic review and meta-analysis
Jehanzeb Ahmed Khan1, Miloni Parmar1, Aditi Bhamare1
1Department of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA.
Insights
Same-day discharge after left atrial appendage occlusion (LAAO) is safe, showing no significant differences in major complications compared to overnight hospital admission. This approach may reduce bleeding and vascular issues, supporting further research.
Area of Science:
- Cardiology
- Interventional Cardiology
- Health Services Research
Background:
- Left atrial appendage occlusion (LAAO) procedures typically involve overnight hospital observation.
- Same-day discharge strategies could optimize resource use in LAAO procedures.
- Evaluating patient safety and post-discharge outcomes is crucial for same-day discharge protocols.
Conclusions:
- Meta-analysis of observational studies indicates that same-day discharge after LAAO is comparable to hospital admission regarding patient safety and post-discharge complications.
- Findings support the potential for same-day discharge in LAAO procedures, with a notable reduction in bleeding and vascular complications.
- A randomized controlled trial is recommended to confirm these findings and mitigate potential confounders.
Introduction:
Most patients undergoing a left atrial appendage occlusion (LAAO) procedure are admitted for overnight observation. A same-day discharge strategy offers the opportunity to improve resource utilization without compromising patient safety. We compared the patient safety outcomes and post-discharge complications between same-day discharge versus hospital admission (HA) (>1 day) in patients undergoing LAAO procedure.
Methods:
A systematic search of MEDLINE and Embase was conducted. Outcomes of interest included peri-procedural complications, re-admissions, discharge complications including major bleeding and vascular complications, ischemic stroke, all-cause mortality, and peri-device leak >5 mm. Mantel-Haenszel risk ratios (RRs) with 95% CIs were calculated.
Results:
A total of seven observational studies met the inclusion criteria. There was no statistically significant difference between same-day discharge versus HA regarding readmission (RR: 0.61; 95% confidence interval [CI]: [0.29-1.31]; p = .21), ischemic stroke after discharge (RR: 1.16; 95% CI: [0.49-2.73]), peri-device leak >5 mm (RR: 1.27; 95% CI: [0.42-3.85], and all-cause mortality (RR: 0.60; 95% CI: [0.36-1.02]). The same-day discharge study group had significantly lower major bleeding or vascular complications (RR: 0.71; 95% CI: [0.54-0.94]).
Conclusions:
This meta-analysis of seven observational studies showed no significant difference in patient safety outcomes and post-discharge complications between same-day discharge versus HA. These findings provide a solid basis to perform a randomized control trial to eliminate any potential confounders.
