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Same-Day Discharge after Cryoballoon Ablation of Atrial Fibrillation: A Multicenter Experience
  • +12
  • Marcin Kowalski,
  • Valay Parikh,
  • Jose Salcido,
  • Nagib Chalfoun,
  • Alfred Albano,
  • Padraig O'Neil,
  • Mark Bowers,
  • Andre Gauri,
  • Kendra Braegelamnn,
  • Hae Lim,
  • Philippe Akhrass,
  • Rina Shah,
  • soad bekheit,
  • Laurence Epstein,
  • Arash Aryana
Marcin Kowalski
Commonwealth University School of Medicine
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Valay Parikh
Staten Island University Hospital
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Jose Salcido
Spectrum Health
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Nagib Chalfoun
Spectrum Health
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Alfred Albano
Spectrum Health
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Padraig O'Neil
Mercy General Hospital and Dignity Health Heart and Vascular Institute
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Mark Bowers
Mercy General Hospital and Dignity Health Heart and Vascular Institute
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Andre Gauri
Spectrum Health
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Kendra Braegelamnn
Medtronic, Inc.
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Hae Lim
Medtronic, Inc.
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Philippe Akhrass
Staten Island University Hospital
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Rina Shah
Staten Island University Hospital
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soad bekheit
Staten Island University Hospital
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Laurence Epstein
Northwell Health
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Arash Aryana
Mercy General Hospital and Dignity Health Heart and Vascular Institute
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Peer review status:UNDER REVIEW

14 Jun 2020Submitted to Journal of Cardiovascular Electrophysiology
15 Jun 2020Assigned to Editor
15 Jun 2020Submission Checks Completed
17 Jun 2020Reviewer(s) Assigned

Abstract

Background: It is common practice to observe patients during an overnight stay (ONS) following a catheter ablation procedure for the treatment of atrial fibrillation (AF). Objectives: To investigate the safety and economic impact of a same day discharge (SDD) protocol after cryoballoon ablation for treatment of AF in high-volume, geographically diverse US hospitals. Methods: We retrospectively reviewed 2,374 consecutive patients (1,119 SDD and 1,180 ONS) who underwent cryoballoon ablation for AF at three US centers. Baseline characteristics and longer-term safety were recorded during follow-up. The mean cost of an ONS was used to evaluate yearly cost savings as a function of the percentage of SDD cases/yearr. Results: There was no difference between SDD and ONS in the 30 day total complication rate [n=15 (1.26%) versus n=24 (2.03%); p=0.136 respectively]. The most common complication was hematoma in both the SDD (n=8; 0.67%) and ONS (n=11; 0.93%) cohorts. Sensitivity analysis demonstrated that when 50% of every 100 patients treated were discharged the same day, hospital cost savings ranged from $45,825 to $83,813 per year across US hospitals. Conclusions: SDD following cryoballoon ablation for AF appears to be safe and is associated with cost savings across different US hospitals.