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Safety and feasibility of same-day discharge for catheter ablation of atrial fibrillation: a systematic review and meta-analysis

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Abstract

Purpose

Most centers performing catheter ablation (CA) of atrial fibrillation (AF) admit the patients for an overnight hospital stay to monitor for post-procedure complications, but the clinical benefits of this overnight hospital admission policy have not been carefully investigated. We hypothesized that same-day discharge strategy is safe and feasible in patients with AF undergoing CA.

Methods

A systematic review of studies comparing the safety of same-day discharge vs hospital admission for AF patients undergoing CA was conducted in PubMed/MEDLINE, Embase, Scopus, and Web of Science. No randomized controlled trials met the inclusion criteria; therefore, observational cohort studies were included. Mantel–Haenszel risk ratios were calculated and I2 statistics were reported for heterogeneity assessment.

Results

A total of 8 observational studies with 10,102 patients were included. There were no statistically significant differences between same-day discharge vs hospital admission in all studied outcomes including post-discharge 30-day hospital visits (RR: 0.90; 95% CI: 0.40–2.02; p = 0.81), post-discharge vascular/bleeding complications (RR: 0.93; 95% CI: 0.46–1.88; p = 0.85), post-discharge stroke/transient ischemic attack/thromboembolism (RR: 0.70; 95% CI: 0.23–2.20; p = 0.55), and post-discharge recurrent arrhythmias (RR: 0.81; 95% CI: 0.60–1.09; p = 0.1).

Conclusion

In carefully selected AF patients undergoing CA, same-day discharge strategy is feasible and safe. There are no significant differences in post-discharge 30-day hospital visits, post-discharge vascular complications, and other safety outcomes. Randomized trials are needed to validate these hypothesis-generating findings.

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Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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Funding

This work was supported by an education research grant from the University of Oklahoma Health Sciences Center College of Medicine, Academy of Teaching Scholars, to Zain Ul Abideen Asad.

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Authors and Affiliations

  1. Department of Medicine, University of Oklahoma Health Sciences Center, 800 Stanton L. Young Blvd. AAT 6300, Oklahoma City, OK, 73104, USA

    Ali Haider Jafry, Khawaja Hassan Akhtar, Jehanzeb Ahmed Khan & Zain Ul Abideen Asad

  2. Robert M. Bird Health Sciences Library, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA

    Shari Clifton

  3. Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA

    Jessica Reese

  4. Department of Medicine, Services Institute of Medical Sciences, Lahore, Pakistan

    Khadija Noor Sami

  5. Department of Medicine, Nishtar Medical College, Multan, Pakistan

    Muhammad Haris Khan

  6. Department of Medicine, University of Mississippi Medical Center, Jackson, MS, USA

    Muhammad Shahzeb Khan

  7. Section of Electrophysiology, Division of Cardiology, University of California San Diego, La Jolla, CA, USA

    Muhammad Bilal Munir

  8. Kansas City Heart Rhythm Institute, Overland Park, KS, USA

    Rakesh Gopinathannair

  9. Duke Clinical Research Institute &, Duke University Medical Center, Durham, NC, USA

    Jonathan P. Piccini

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  1. Ali Haider Jafry
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Contributions

Conceptualization: Ali Haider Jafry, MD; Khawaja Hassan Akhtar, MD. Methodology: Ali Haider Jafry; Jehanzeb Ahmed Khan, MD; Khawaja Hassan Akhtar, MD. Formal analysis and investigation: Ali Haider Jafry, MD; Khawaja Hassan Akhtar, MD; Shari Clifton, MLIS; Jessica Reese, PhD; Khadija Noor Sami, MBBS; Muhammad Haris Khan, MD. Writing — original draft preparation: Ali Haider Jafry; Khawaja Hassan Akhtar; Jehanzeb Ahmed Khan. Writing — review and editing: Muhammad Shahzeb Khan, MD; Muhammad Bilal Munir, MD; Rakesh Gopinathannair, MD; Jonathan P. Piccini, MD, MHS; Zain Ul Abideen Asad, MD, MS. Funding acquisition: Zain Ul Abideen Asad, MD, MS. Resources: Shari Clifton, MLIS; Jessica Reese, PhD; Zain Ul Abideen Asad, MD, MS. Supervision: Zain Ul Abideen Asad, MD, MS.

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Correspondence to Ali Haider Jafry.

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Jafry, A., Akhtar, K., Khan, J. et al. Safety and feasibility of same-day discharge for catheter ablation of atrial fibrillation: a systematic review and meta-analysis. J Interv Card Electrophysiol 65, 803–811 (2022). https://doi.org/10.1007/s10840-022-01145-9

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