Safety and feasibility of same-day discharge in patients receiving pulmonary vein isolation-systematic review and a meta-analysis

J Interv Card Electrophysiol. 2022 Mar;63(2):251-258. doi: 10.1007/s10840-021-00967-3. Epub 2021 Feb 25.

Abstract

Purpose: The purpose of this systematic review and meta-analysis was to evaluate the feasibility and safety of a same-day discharge protocol following pulmonary vein isolation (PVI).

Methods: PubMed and Embase were systematically investigated from the inception to 20 July 2020. Studies on safety and feasibility of PVI for atrial fibrillation (AF) were included. Study-specific estimates were combined using one-group meta-analysis with a random-effects model.

Results: Seven observational studies investigating the safety and feasibility of same-day discharge protocols were identified. Of a total of 3656 patients who have undergone PVI for AF, the overall complication rate was 0.80% (95% confidence interval [CI], 0.20-1.40%). The readmission within 30-day following same-day discharge protocol occurred at a pooled rate of 3.6% (95% CI, 0.0-8.4%). Frequent complications following the procedure were complications related to vascular access (0.38%; 95% CI, 0.18-0.58%), and phrenic nerve injury (0.19%; 95% CI, 0.05-0.33%). The reported complications in SDD group were mainly based on results among patients without perioperative complications.

Conclusions: The introduction of same-day discharge strategies might be safe and feasible in selected patients given the reported complication and re-admission rates in the current practice. Further prospective studies are needed to confirm these findings.

Keywords: Atrial fibrillation; Catheter ablation; Complication; Pulmonary vein isolation; Readmission; Same-day discharge.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Atrial Fibrillation* / surgery
  • Catheter Ablation* / methods
  • Feasibility Studies
  • Humans
  • Patient Discharge
  • Pulmonary Veins* / surgery
  • Treatment Outcome