Same-day discharge for AF ablation increases, improving efficiency over time
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An analysis of single-center data showed same-day discharge after atrial fibrillation ablation increased from 2020 to 2021, with reduction in total time spent in-hospital and no change in readmission rates for adverse events.
Same-day discharge after AF ablation may be associated with improved patient satisfaction and reduced hospital resource utilization, Bruce A. Koplan, MD, MPH, FHRS, a cardiac electrophysiologist and assistant professor of medicine at Brigham and Women’s Hospital, and colleagues wrote in an abstract presented at Heart Rhythm 2022.
“As this new care strategy is incorporated, it is important to understand factors associated with success and safety,” the researchers wrote.
The researchers analyzed data from 602 patients who underwent AF ablation at a single site from December 2020 to November 2021; all were considered eligible for same-day discharge. The mean age of patients was 64 years; 35% were women. Allied health professionals determined eligibility protocol, which included case completion by 2 p.m., companion to stay overnight, allied health professional assessment and next-day virtual telehealth visit by an allied health professional. Researchers compared characteristics and predictors of success over time among patients who had a same-day discharge compared with those who did not.
Among the first 200 patients who underwent AF ablation (group 1), same-day discharge was successful for 64.2% of intended same-day discharge patients. Among the subsequent 402 patients who underwent AF ablation (group 2), same-day discharge was successful for 84.7% of intended same-day discharge patients (P < .01). Vascular access management and urinary retention were the most common causes of failure to discharge on the same day.
Patients who were not deemed eligible for same-day discharge were older (mean, 66 years vs. 61 years; P < .01), had a higher BMI (mean, 29 kg/m2 vs. 28 kg/m2; P < .05) and a higher CHADs-VASc score (mean, 2.4 vs. 1.8; P < .05) compared with the intended same-day discharge patients in both groups.
Among all patients, more underwent same-day discharge from group 2 vs. group 1 (23.4% vs. 17%). Same-day discharge patients from group 2 were older compared with group 1 (mean, 63 years vs. 57 years; P = .05). Additionally, the total time from patient arrival until same-day discharge also improved from group 1 to group 2, from a mean of 12.9 hours to a mean of 12 hours, according to researchers.
Readmission for adverse events occurred among 1.6% of same-day discharge patients and 1.7% of non-same-day discharge patients; the adverse event rate was similar for groups 1 and 2 (2.9% vs. 1.1%).
“An AF ablation same-day discharge program overseen by allied health professionals can be performed with increasing success, increasing patient eligibility and efficiency over time,” the researchers wrote. “Allied health professional resource utilization and further process improvements are essential to this important care strategy.”
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Rousseau LA, et al. Abstract AP-519. Presented at: Heart Rhythm 2022; April 29-May 1, 2022; San Francisco (hybrid meeting).
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