Same-Day Discharge in Ventricular Ablation: Safety Outcomes and Case Selection
Eric Xie1, Jody Viola1, Sydney Ness1
1Division of Cardiology, Duke University Medical Center, Durham, North Carolina, USA.
Insights
Same-day discharge (SDD) after catheter ablation (CA) for ventricular arrhythmias (VA) is safe and feasible, particularly for low-risk patients. This approach enables efficient patient management without compromising safety outcomes.
Area of Science:
- Cardiac Electrophysiology
- Interventional Cardiology
- Medical Device Technology
Background:
- Catheter ablation (CA) for ventricular arrhythmias (VA) traditionally requires overnight hospitalization.
- Limited data exists on the outcomes of same-day discharge (SDD) following VA ablation.
- No prior comparative studies have evaluated SDD in the context of VA ablation.
Purpose of the Study:
- To compare the outcomes of same-day discharge (SDD) versus overnight stay after catheter ablation (CA) for ventricular arrhythmias (VA).
- To identify patient characteristics and procedural factors associated with successful SDD in VA ablation.
- To assess the safety and feasibility of SDD for VA ablation patients.
Main Methods:
- A single-center prospective comparative observational study.
- 255 consecutive patients undergoing elective CA for PVC or VT between April 2023 and June 2025.
- Exclusion of patients with planned admissions; SDD determined by physician discretion; routine telephone follow-up.
Main Results:
- 48% of patients (123/255) underwent SDD.
- SDD patients had higher ejection fraction (EF), less arterial access, and lower PAINESD scores compared to overnight stay patients.
- Low rates of major access site complications (1.6%) and other adverse events (0.8%) were observed within 30 days.
Conclusions:
- Same-day discharge (SDD) is a feasible and safe strategy for patients undergoing catheter ablation (CA) for premature ventricular contractions (PVCs).
- SDD may be suitable for a subset of patients undergoing ventricular tachycardia (VT) ablation.
- Favorable characteristics for SDD include low-to-moderate risk patients, early procedure timing, use of closure devices, and dedicated nursing follow-up.
Introduction:
Catheter ablation (CA) of ventricular arrhythmias (VA) has traditionally entailed an overnight stay, and little has been published on outcomes of same-day discharge (SDD) in this population. Thus far, no comparative study of SDD in VA ablation has been described.
Methods:
This was a single-center prospective comparative observational study of 255 consecutive patients undergoing elective CA of VA (PVC or VT) in the outpatient setting between April 2023 and June 2025. We excluded patients who were pre-admitted or planned for admission or overnight stays post-ablation. SDD was at the attending physician's discretion. Post-discharge, patients had routine telephone follow-up to monitor for complications.
Results:
Among 255 patients undergoing ablation for ventricular arrhythmia, 123 (48%) underwent SDD. Patients undergoing SDD had a mean age of 61 ± 16, 38% were female, 33% had heart failure, and the majority had CA for PVC (96%). Compared with those who stayed overnight, SDD patients had higher EF (50% vs. 46%, p = 0.003), less arterial access (48% vs. 62%, p = 0.02), and lower PAINESD score (3.4 vs. 4.8, p = 0.04). Over 30 days of follow-up, two patients (1.6%) had major access site complications, and one (0.8%). Based upon these observations, we describe favorable characteristics for SDD in CA of VA, with the key features of including low-to-moderate risk patients, early case timing, liberal closure device usage, and close follow-up by a dedicated clinical nurse.
Conclusion:
SDD is feasible and safe for patients undergoing PVC ablation and potentially a subset of patients undergoing VT ablation.
