Zylla, Maura M., Imberti, Jacopo F., Leyva, Francisco, Casado-Arroyo, Ruben, Braunschweig, Frieder, Pürerfellner, Helmut, Merino, José L. and Boriani, Giuseppe (2024). Same-day discharge vs. overnight stay following catheter ablation for atrial fibrillation: a comprehensive review and meta-analysis by the European Heart Rhythm Association Health Economics Committee. Europace, 26 (8),
Abstract
Aims: Same-day discharge (SDD) after catheter ablation of atrial fibrillation (AF) may address the growing socio-economic health burden of the increasing demand for interventional AF therapies. This systematic review and meta-analysis analyses the current evidence on clinical outcomes in SDD after AF ablation compared with overnight stay (ONS). Methods and results: A systematic search of the PubMed database was performed. Pre-defined endpoints were complications at short-term (24–96 h) and 30-day post-discharge, re-hospitalization, and/or emergency room (ER) visits at 30-day post-discharge, and 30-day mortality. Twenty-four studies (154 716 patients) were included. Random-effects models were applied for meta-analyses of pooled endpoint prevalence in the SDD cohort and for comparison between SDD and ONS cohorts. Pooled estimates for complications after SDD were low both for short-term [2%; 95% confidence interval (CI): 1–5%; I2: 89%) and 30-day follow-up (2%; 95% CI: 1–4%; I2: 91%). There was no significant difference in complications rates between SDD and ONS [short-term: risk ratio (RR): 1.62; 95% CI: 0.52–5.01; I2: 37%; 30 days: RR: 0.65; 95% CI: 0.42–1.00; I2: 95%). Pooled rates of re-hospitalization/ER visits after SDD were 4% (95% CI: 1–10%; I2: 96%) with no statistically significant difference between SDD and ONS (RR: 0.86; 95% CI: 0.58–1.27; I2: 61%). Pooled 30-day mortality was low after SDD (0%; 95% CI: 0–1%; I2: 33%). All studies were subject to a relevant risk of bias, mainly due to study design. Conclusion: In this meta-analysis including a large contemporary cohort, SDD after AF ablation was associated with low prevalence of post-discharge complications, re-hospitalizations/ER visits and mortality, and a similar risk compared with ONS. Due to limited quality of current evidence, further prospective, randomized trials are needed to confirm safety of SDD and define patient- and procedure-related prerequisites for successful and safe SDD strategies.
Publication DOI: | https://doi.org/10.1093/europace/euae200 |
---|---|
Divisions: | College of Health & Life Sciences > Aston Medical School > Translational Medicine Research Group (TMRG) College of Health & Life Sciences > Aston Medical School |
Additional Information: | Copyright © The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited. |
Uncontrolled Keywords: | Atrial fibrillation,Re-hospitalization,Same-day discharge,Complications,Catheter ablation,Mortality |
Publication ISSN: | 1532-2092 |
Last Modified: | 14 Aug 2024 15:34 |
Date Deposited: | 14 Aug 2024 15:34 |
Full Text Link: | |
Related URLs: |
https://academi ... euae200/7723783
(Publisher URL) |
PURE Output Type: | Review article |
Published Date: | 2024-08 |
Published Online Date: | 2024-07-30 |
Accepted Date: | 2024-07-25 |
Authors: |
Zylla, Maura M.
Imberti, Jacopo F. Leyva, Francisco Casado-Arroyo, Ruben Braunschweig, Frieder Pürerfellner, Helmut Merino, José L. Boriani, Giuseppe |