Key result
Same-day discharge following atrial fibrillation ablation had similar total cumulative complications compared with overnight stay (5.2% vs. 6.2%; OR 0.77; 95% CI 0.55-1.08; p=0.13).
Why the study?
Practice has shifted toward same-day discharge after AF ablation, but safety profiles remain poorly understood and dispersed across recent studies.
Does same-day discharge improve or worsen complication rates compared to overnight stay in patients undergoing atrial fibrillation ablation?
Meta-Analysis (n=11,660)
Does same-day discharge improve or worsen complication rates compared to overnight stay in patients undergoing atrial fibrillation ablation?
Odds Ratio: 0.77 (95% CI 0.55–1.08)
Absolute Event Rate: 5.2% vs 6.2%
p-value: p=0.13
Same-day discharge after atrial fibrillation ablation appears safe with comparable complication rates to overnight stay, supporting the shift toward outpatient management in selected patients.
May support same-day discharge after AF ablation in selected patients; leaves open need for randomized confirmation.
Background In the modern era, atrial fibrillation (AF) ablation trend has been shifted toward same‐day discharge (SDD), from a traditional overnight stay. Yet, recent studies have not well stated the safety profiles which remained poor‐understood and dispersed. We hence performed systematic review and meta‐analysis to assess the adverse outcomes of SDD in comparison with an overnight stay. Methods Databases were searched through January 2021. Effect estimates from the individual studies were extracted and combined using random‐effects, generic inverse variance method of der Simonian and Laird. The primary outcomes included total cumulative complications and immediate complications following AF ablation. Results Ten observational studies were met our inclusion criteria, comprising of total population of 11,660 patients, with SDD 51.3%. For total cumulative complications, there were no differences observed between SDD and overnight stay (5.2% vs. 6.2%: pooled OR 0.77: 95% CI 0.55–1.08, p = .13 with I 2 = 27.1%). In addition, comparable immediate complications were also demonstrated (5.2 % vs. 4.3: pooled OR 1.08: 95% CI 0.72–1.62, p = .718, with I 2 = 37.3 %). Conclusion Our study suggested that SDD had similar complication rates, both total cumulative and immediate outcomes, compared with overnight stay in selected patients following AF ablation. Nevertheless, randomized control trials are warranted to validate the findings.
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Prasitlumkum et al. (2021) conducted a meta-analysis in Atrial fibrillation (n=11,660). Same-day discharge vs. Overnight stay was evaluated on Total cumulative complications (OR 0.77, 95% CI 0.55-1.08, p=0.13). Same-day discharge following atrial fibrillation ablation had similar total cumulative complications compared with overnight stay (5.2% vs. 6.2%; OR 0.77; 95% CI 0.55-1.08; p=0.13).
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