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

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.