Same-day discharge versus overnight stay after catheter ablation for atrial fibrillation: a systematic review and meta-analysis.
Martín Rebolledo Del Toro, Maria Alejandra Robledo Gomez, Oscar Mauricio Muñoz-Velandia et al.
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In 30 seconds
This systematic review and meta-analysis compared protocolized same-day discharge with overnight hospitalization after pulmonary vein isolation for atrial fibrillation in adults. Nineteen studies involving 26,335 patients were included: two randomized trials and 17 non-randomized studies. Across structured programs, same-day discharge was successful in an average of 89% of cases. At 30 days, it was not associated with excess readmissions or emergency visits; the pooled estimate favored same-day discharge (OR 0.63; 95% CI 0.51-0.78; I² 0%). Mortality was rare and did not differ between strategies.
Key findings
- Same-day discharge success averaged 89% across structured programs.
- At 30 days, the pooled estimate for readmissions or emergency visits favored same-day discharge (OR 0.63; 95% CI 0.51-0.78; I² 0%).
- Mortality was rare in both groups, with no pooled difference between discharge strategies.
- Complication rates were low in both groups, although definitions varied.
Why it matters
The findings suggest that structured same-day discharge can be a feasible alternative to overnight hospitalization for selected patients after atrial fibrillation ablation, without an observed increase in short-term unplanned healthcare use or mortality. The evidence is less conclusive for higher-risk patients, so the results support careful selection and follow-up rather than broad generalization.
What to keep in mind
Most included studies were non-randomized and had moderate to serious risk of bias; complication definitions varied. The authors note that further randomized trials are needed, particularly in higher-risk populations and with newer ablation technologies.