Comparison between same-day discharge and overnight stay after atrial fibrillation ablation: Systematic review and meta-analysis

Pacing Clin Electrophysiol. 2021 Dec;44(12):2054-2066. doi: 10.1111/pace.14380. Epub 2021 Oct 26.

Abstract

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 I2 = 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 I2 = 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.

Keywords: atrial fibrillation ablation; overnight stay; same day discharge.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Atrial Fibrillation / surgery*
  • Catheter Ablation*
  • Humans
  • Length of Stay*
  • Patient Discharge*
  • Postoperative Complications