Abstract
BackgroundAs same-day discharge (SDD) after catheter ablation (CA) for atrial fibrillation (AF) is increasingly utilized, it is important to further investigate this approach.ObjectiveTo investigate the safety and efficacy of SDD after CA for AF in a large nationwide administrative sample.MethodsThe IBM MarketScan Commercial Claims and Encounters database was used to identify adult patients under 65 years undergoing CA for AF (2016–2020). Eligible patients were indexed to date of first CA and classified into SDD or overnight stay (ONS) groups based on length of service. A 1:3 propensity score matching was used to create comparable SDD:ONS samples. Study outcomes were CA-related complications within 30 days after index procedure and AF recurrence within 1 year. Cox proportional hazards models were estimated for outcome comparison.ResultsIn the postmatch 30-day cohort, there were 1610 SDD and 4637 ONS patients with mean age 56.1 (± 7.6) years. There was no significant difference in composite 30-day postprocedural complication rate between SDD and ONS groups (2.7% vs 2.8%, respectively; P = .884). The most common complications were cerebrovascular events (0.7% vs 0.7%; P = .948), vascular access events (0.6% vs 0.6%; P = .935), and pericardial complications (0.6% vs 0.5%; P = .921). Further, no significant difference in composite AF recurrence rate at 1 year was observed among SDD and ONS groups (10.2% vs 8.8%; hazard ratio = 1.167; 95% confidence interval 0.935–1.455; P = .172).ConclusionIn a large, propensity-matched, real-world sample, SDD appears to be safe and have similar outcomes compared with overnight observation following CA for AF.
Highlights
Atrial fibrillation (AF) is the most common form of arrhythmia among adults in the United States (US).[1]
In a large, propensity-matched, real-world sample, same-day discharge (SDD) appears to be safe and have similar outcomes compared with overnight observation following catheter ablation (CA) for AF
1 patient from the SDD group was dropped after propensity score matching (PSM), and all baseline covariates were balanced between SDD and overnight stay (ONS) with the absolute values of SMD less than 0.1
Summary
Atrial fibrillation (AF) is the most common form of arrhythmia among adults in the United States (US).[1]. A recent editorial highlighted the limitations of current evidence supporting the safety and efficacy of CA with SDD.[19]. These limitations include the following: (1) lack of consideration of the impact of transesophageal echocardiography use and body mass index on the procedural outcomes; (2) limited evidence investigating patients with nonparoxysmal AF; and (3) study period not reflective of current practices. As same-day discharge (SDD) after catheter ablation (CA) for atrial fibrillation (AF) is increasingly utilized, it is important to further investigate this approach
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
