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

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Journal of Interventional Cardiac Electrophysiology Aims and scope Submit manuscript

Abstract

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.

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Abbreviations

AF:

Atrial fibrillation

CI:

Confidence interval

HR:

Hazard ratio

SDD:

Same-day discharge

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Authors and Affiliations

  1. Department of Cardiology, Gifu University Graduate School of Medicine, Gifu, Japan

    Yuki Sahashi

  2. Department of Health Data Science, Graduate School of Data Science, Yokohama City University, Yokohama, Japan

    Yuki Sahashi

  3. Helmsley Electrophysiology Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA

    Iwanari Kawamura

  4. Cardiovascular Research Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA

    Tadao Aikawa

  5. Department of Cardiovascular Surgery, Shizuoka Medical Center, Shizuoka, Japan

    Hisato Takagi

  6. Division of Cardiovascular Diseases, University of Iowa Hospitals and Clinics, Iowa City, USA

    Alexandros Briasoulis

  7. Department of Medicine, Icahn School of Medicine at Mount Sinai, Mount Sinai Beth Israel, First Avenue, 16th Street, New York, NY, 10003, USA

    Toshiki Kuno

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  1. Yuki Sahashi
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  2. Iwanari Kawamura
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  3. Tadao Aikawa
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Correspondence to Toshiki Kuno.

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Sahashi, Y., Kawamura, I., Aikawa, T. et al. Safety and feasibility of same-day discharge in patients receiving pulmonary vein isolation—systematic review and a meta-analysis. J Interv Card Electrophysiol 63, 251–258 (2022). https://doi.org/10.1007/s10840-021-00967-3

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  • DOI: https://doi.org/10.1007/s10840-021-00967-3

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