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Updated: Sep 2, 2026
Reduced Procedure Time and Variability with Active Esophageal Cooling During Radiofrequency Ablation for Atrial Fibrillation
Published on: August 25, 2022
Safety and Efficacy of Nighttime Versus Daytime Radiofrequency Catheter Ablation for Atrial Fibrillation: A
Zhuangzhuang Niu1, Jiongchao Guo2, Conghui Shang3
1The Third Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China.
Objective:
This study aimed to compare the incidence of post‑procedural complications in patients undergoing radiofrequency catheter ablation (RFCA) for atrial fibrillation (AF) performed during daytime versus nighttime hours.
Methods:
This retrospective study included 2951 patients who underwent AF ablation at three centers between 2019 and 2024. Based on procedure start time, patients were assigned to a daytime group (08:00-16:00, n = 1503) or a nighttime group (16:00-24:00, n = 1301). Propensity score matching (PSM) was used to balance baseline characteristics. The primary outcome was any complication within 3 months post‑ablation. Secondary outcomes included in‑hospital and post‑discharge complications (within 3 months) and freedom from atrial arrhythmia recurrence at 12 months.
Results:
Following 1:1 PSM, 1263 matched pairs were analyzed. The overall postoperative complication rate was significantly higher in the nighttime group than in the daytime group (4.99% vs. 2.30%; odds ratio [OR]: 2.23; 95% confidence interval [CI]: 1.43-3.49; p < 0.001). This elevated risk was consistent for both in-hospital complications (OR: 2.14; 95% CI: 1.23-3.72; p = 0.007) and post-discharge complications (OR: 2.32; 95% CI: 1.10-4.90; p = 0.027). Furthermore, there was no significant difference in the 12-month freedom from atrial arrhythmia recurrence between the two cohorts.
Conclusions:
Nighttime AF ablation is associated with a significantly increased risk of overall postoperative complications, highlighting procedural timing as a critical determinant of perioperative patient safety.
