Same-Day Discharge after Cryoballoon Ablation of Atrial Fibrillation: A
Multicenter Experience
Abstract
Background: It is common practice to observe patients during an
overnight stay (ONS) following a catheter ablation procedure for the
treatment of atrial fibrillation (AF). Objectives: To investigate the
safety and economic impact of a same day discharge (SDD) protocol after
cryoballoon ablation for treatment of AF in high-volume, geographically
diverse US hospitals. Methods: We retrospectively reviewed 2,374
consecutive patients (1,119 SDD and 1,180 ONS) who underwent cryoballoon
ablation for AF at three US centers. Baseline characteristics and
longer-term safety were recorded during follow-up. The mean cost of an
ONS was used to evaluate yearly cost savings as a function of the
percentage of SDD cases/yearr. Results: There was no difference between
SDD and ONS in the 30 day total complication rate [n=15 (1.26%)
versus n=24 (2.03%); p=0.136 respectively]. The most common
complication was hematoma in both the SDD (n=8; 0.67%) and ONS (n=11;
0.93%) cohorts. Sensitivity analysis demonstrated that when 50% of
every 100 patients treated were discharged the same day, hospital cost
savings ranged from $45,825 to $83,813 per year across US hospitals.
Conclusions: SDD following cryoballoon ablation for AF appears to be
safe and is associated with cost savings across different US hospitals.