Policy, Payment & Practice -> Reimbursement, Regulation and Health Policy D-PO06 - Poster Session VI (ID 26) Poster

Abstract

Background: It is common practice to observe patients overnight following a catheter ablation for treatment of AF. A same day discharge (SDD) strategy for cryoballoon (CB) AF ablation may be feasible, but the safety of SDD has not been compared to patients kept for an overnight stay (ONS) in a multicenter study.
Objective: The aim was to investigate the safety and efficacy of a SDD protocol after CB ablation of AF compared to ONS in a multicenter retrospective study.
Methods: We reviewed 2,374 consecutive patients who underwent CB ablation for AF at 3 US centers. All patients underwent PVI using the CB catheter. The decision to undergo a SDD protocol was up to the operator. Patients who qualified for SDD were discharged from the hospital within 6 h. This cohort was compared to patients admitted to the hospital for ONS. Characteristics and complications rates were collected from the time of the procedure until 30 days post ablation.
Results: The SDD cohort (n=1194) significantly differed from the ONS cohort (n=1180) in age (64 vs 66 p< 0.001), BMI (30 vs 31 p< 0.001), and CHADVSC score (1.4 vs 2.2 p< 0.002). There was no difference in sex (825 vs 793 males p=0.3), DM (226 vs 246 p=0.2) or TIA (56 vs 65 p=0.4) between groups. There was no difference between groups in 30 days total complication rate (n=15 (1.26%) vs n=24 (2.03%); p=0.136 respectively). The most common complication was hematoma (graph). None of the complications or ER visit in SDD cohort occurred within 48 hours post ablation, suggesting observed events would not been prevented by ONS.
Conclusion: The SDD of a patient following a CB ablation for AF appears to be a safe protocol in comparison to an overnight stay with broad application across different hospitals.
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