B-PO05-114 SAFETY OUTCOMES OF SAME-DAY DISCHARGE FOLLOWING ABLATION FOR ATRIAL FIBRILLATION OR LEFT ATRIAL FLUTTER

Abstract

Overnight monitoring after ablation of atrial fibrillation is the standard protocol. This approach stems from the concern for complications within 24 hours after the procedure. Advances in intra-cardiac echocardiogram, increased resolution of 3D electro-anatomical mapping, force-sensing catheters, and improved vascular access management have allowed for a significant decrease in cardiac perforation or groin hematomas. In addition to increased safety, the concerns related to hospital stays during COVID era signaled the need for same day discharge (SDD) consideration. Compare the safety outcomes and patient satisfaction on discharges the same day of procedure versus current standard of care. This study enrolled patients who underwent catheter ablation for atrial fibrillation or left atrial flutter from June 2020 to January 2021 at the University of Cincinnati Medical Center. SDD group was composed of patients who were free from complications for a minimum of 8 hours post procedure and discharged home the same day. The complications monitored during the 8-hours included hypotension with suspected tamponade, stroke, groin hematomas, or any abnormal rhythms noted on predischarge ECG. Standard of care was defined as those patients who remained in the hospital for 24-hours post procedure. Studied outcomes compared the procedure-related complications occurring within versus after the 8-hours post-procedure in the two groups. Additionally, an informal patient satisfaction survey was conducted between the two groups by collecting data from the next day phone follow-up and 1-month clinic visit. A total of 100 patients met inclusion criteria. Fifty-six (56%) patients were in the SDD group, whereas 44 (44%) received standard of care. Same-day discharge and standard of care patients had no significant difference in late procedure-related complications (less than 1% in both groups). Additionally, the SDD group displayed equivalent patient satisfaction as compared to the standard of care patients on follow-up phone call. Compared to the standard of care, same-day discharge provides equivalent patient safety and satisfaction. This has great implications for healthcare economics, especially in COVID-19 era.