Safety and efficacy of same-day discharge for premature ventricular complex ablations

Author:

Padanilam Mathew S1ORCID,Patel Parin J2ORCID,Joshi Sandeep A2ORCID,Nair Girish V2ORCID,Clark Bradley A2ORCID,Shah Ankur2ORCID,Field Justin2,Prystowsky Eric N2,Gilge Jasen L2ORCID

Affiliation:

1. Department of Internal Medicine, University of Chicago , 5841 South Maryland Avenue, MC 7082, Chicago, IL 60637, USA

2. Department of Internal Medicine, Division of Cardiology, Ascension St Vincent , 8333 Naab Road, #400, Indianapolis, IN 46260, USA

Abstract

Abstract Aims Patients undergoing catheter ablation (CA) of ventricular arrhythmias (VAs) are generally observed overnight in the hospital given the concern for complications. To evaluate the efficacy and safety of same-day discharge (SDD) of patients undergoing elective CA of premature ventricular complexes (PVCs). Methods and results A retrospective evaluation of all patients undergoing elective VA ablation at Ascension St Vincent Hospital from 1 January 2018 to 31 December 2019 was undertaken. Of those, the patients undergoing PVC ablation were divided into SDD and non-SDD. Patients underwent SDD at the discretion of the operator. The primary safety outcome was the 30-day incidence of complications and death. The primary efficacy outcome was procedural success. Among 188 patients who underwent VA ablation, 98 (52.1%) were PVC ablations, and of those, 55 (56.1%) were SDD. There was no difference in age, gender, comorbidities, or ejection fraction between the two groups. Patients that were non-SDD were more likely to be on chronic anticoagulation (P = 0.03), have ablation in the LV (P = 0.04), have retrograde access (P = 0.03), and receive heparin during the procedure (P = 0.01). There were no complications in the SDD group compared with one (2.3%) in the non-SDD group. There was no difference in primary efficacy between the two groups with a 90.9% acute success in the SDD and 88.4% in the non-SDD (P = 0.68). Conclusion Same-day discharge for CA of PVCs is feasible and could lower healthcare resource utilization without compromising outcomes in this unique population.

Funder

St Vincent Cardiovascular Research Institute

Publisher

Oxford University Press (OUP)

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