Same-day discharge after catheter ablation for routine arrhythmias: an initial experience

Aim. Same-day discharge (SDD) in the setting of catheter ablation (CA) is not widely applied. We present our experience concerning SDD in a selected population of patients who underwent CA; the outcome was evaluated in terms of feasibility and safety. Methods. 401 CA procedures were performed at our institution between January 2008 and December 2009 in 379 patients (65 +/- 16 years, 221 men). 336 CA procedures (84%) were considered eligible for SDD, after the exclusion of ventricular arrhythmias, atrial fibrillation, atypical atrial flutter, AV node ablation as well as procedures involving an arterial or transseptal access. Subsequently, a number of clinical and organizational exclusion criteria were applied. Results. 223 patients were actually discharged on the same day of CA (56% of 401 overall CA procedures): 114 atrial flutter (AFL) and 109 supraventricular tachycardia. Many patients were excluded before CA due to a limited availability of the day-hospital facility; this occurred more frequently in the year 2008 than 2009 (45 vs. 2, P=0.0001); in the year 2009 the rate of total CA procedures which underwent SDD was of 68%. Overall, three groin hematomas occurred, all in patients ablated for AFL. Two of them were recognized during the postablation observation period. All hematomas resolved spontaneously without intervention. Conclusion. SDD can be safely performed in most patients undergoing CA for routine arrhythmias. This may result in a significant impact on daily practice in terms of both organizational improvement and subjective benefit for the patients.