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Safety and feasibility of same-day discharge following catheter ablation of atrial fibrillation: what is known and what needs to be explored?

Sicherheit und Machbarkeit der tagesklinischen Durchführung von Katheterablationen bei Vorhofflimmern – Wissensstand und Forschungsbedarf

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Abstract

Catheter ablation of atrial fibrillation (AF) is the most effective rhythm control strategy and its role in the treatment of AF patients has been strengthened by recent guidelines. An increasing AF prevalence and the resulting demands on interventional electrophysiology call for improved resource allocation through both technical innovations and streamlined workflows and patient pathways. Same-day discharge is already established in the context of other electrophysiological interventions; however, its broad implementation in the practice of AF ablation is pending for several reasons, despite the fact that the body of evidence is growing and the majority of reports propagate early discharge to be feasible and safe under certain conditions. This review article is intended to provide an overview of the existing data, classify these into the specific study context, and to show limitations and open questions.

Zusammenfassung

Die Katheterablation stellt die effektivste Form der Rhythmuskontrolle bei Patienten mit Vorhofflimmern (VHF) dar und die Indikation zur Intervention wurde durch die aktuellen europäischen Leitlinien nochmals gestärkt. Angesichts des demografischen Wandels und der damit verbundenen steigenden Prävalenz von VHF ist eine Optimierung der Ressourcenallokation elektrophysiologischer Zentren notwendig, um der steigenden Nachfrage an Katheterablationen gerecht werden zu können. Neben technischen Innovationen der Prozedur selbst sind Anpassungen der stationären Arbeitsabläufe und Behandlungspfade vielversprechende Angriffspunkte. Eine breite Umsetzung in Bezug auf die Katheterablation bei VHF erfolgt jedoch bislang aus unterschiedlichen Gründen nicht, obwohl eine wachsende Zahl an Studien die Machbarkeit und Sicherheit einer früheren Entlassung unter Berücksichtigung bestimmter Voraussetzungen belegt. Ziel dieses Übersichtsbeitrags ist es, die aktuell verfügbaren Daten darzulegen, sie im jeweiligen Studienkontext einzuordnen sowie Limitationen und offene Fragen zu beleuchten.

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Authors and Affiliations

  1. Department of Electrophysiology, Heart Center Leipzig at University of Leipzig, Strümpellstr. 39, 04289, Leipzig, Germany

    Sebastian König MD, Sergio Richter MD, Andreas Bollmann MD, PhD & Gerhard Hindricks MD

  2. Leipzig Heart Institute, Leipzig, Germany

    Sebastian König MD, Sergio Richter MD, Andreas Bollmann MD, PhD & Gerhard Hindricks MD

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  1. Sebastian König MD
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  2. Sergio Richter MD
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Correspondence to Sebastian König MD.

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S. König, S. Richter, A. Bollmann, and G. Hindricks declare that they have no competing interests.

For this article no studies with human participants or animals were performed by any of the authors. All studies performed were in accordance with the ethical standards indicated in each case.

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König, S., Richter, S., Bollmann, A. et al. Safety and feasibility of same-day discharge following catheter ablation of atrial fibrillation: what is known and what needs to be explored?. Herz 47, 123–128 (2022). https://doi.org/10.1007/s00059-022-05102-0

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