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.
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