[Feasibility and safety of a "Fast-Track" same-day discharge protocol following percutaneous left atrial appendage...

Percutaneous left atrial appendage closure (LAAC) is a validated alternative to long-term oral anticoagulation in patients with atrial fibrillation at high hemorrhagic risk or presenting a contraindication to anticoagulants. Post-procedural monitoring traditionally relies on hospitalization for at least one night, the systematic necessity of which is increasingly being questioned.

To evaluate the feasibility and safety of a same-day ambulatory discharge ("FastTrack") protocol following LAAC in our center.

Single-center study prospectively including 50 patients who underwent LAAC at CHU de la Timone between January and June 2026. Twenty-three patients (46.0%) were eligible for "FastTrack" (FT+), of whom 18 (78.3%) were actually discharged the same day (FT+/+) and 5 (21.7%) ultimately could not benefit from it (FT+/-). In the per-protocol analysis (FT+/+ versus FT-+FT+/-, n=32), the primary endpoint - 30day hospital readmission (pericardial tamponade, major bleeding, ischemic stroke/TIA, hemorrhagic stroke, systemic embolism, death) - occurred in 1 FT+/+ patient (5.6%; 95% CI 1.0-25.8%), related to a death of non-cardiovascular cause, versus no event in the remainder of the cohort (0.0%; 95% CI 0.0-10.7%; P=0.36). Median length of hospital stay was 0 days in the FT+/+ group versus 1 day in the rest of the cohort.

Same-day discharge after LAAC appears feasible and safe in selected patients. The only 30-day readmission event observed in the cohort, not significantly different between groups, was a death of non-cardiovascular cause. These preliminary results require confirmation in a larger cohort.