Arrhythmias & electrophysiology
Clinical and economic outcomes of a systematic same-day discharge programme after pulmonary vein isolation: comparison between cryoballoon vs. radiofrequency ablation
Authors' conclusion
In a systematic SDD programme, feasibility (95%, increasing over time), safety (11% UUC-10, 1.7% re-hospitalizations), and savings (63% per procedure) were similar for CRYO and RF ablation procedures.
Study context
- Population
- Scheduled pulmonary vein isolation (PVI) in a systematic same-day discharge programme, single institution, 1 April 2019 to 31 December 2022617 same-day discharge (SDD)-programme PVI
- Participants
- 377 / 240 / 100
- Exposure
- Cryoballoon vs radiofrequency ablation in a systematic same-day discharge programme
- Cryoballoon (CRYO)n = 377
- Radiofrequency (RF)n = 240reference
- Controln = 100
- Outcome
- Feasibility of same-day discharge, 10-day urgent/unplanned medical care after discharge (UUC-10), and cost per procedure
Methodological detailssingle-centre, consecutive procedures, historical control
- Single-centre
- Consecutive procedures
- Historical control
Main finding
As reported in the abstract
Same-day discharge achieved
- Overall SDD 585/617
- 95%
- Significant trend towards higher monthly SDD rate 2019–2022
- P = 0.03
Observational data: associations, not effects.
Further findings
Cost per procedure
- Average savings per procedure with SDD (vs systematic hospitalization)
- 63%
- SDD savings P
- P < 0.001
- No differences CRYO vs RF
- P = 0.8
Safety
| Outcome | CRYO | RF | Control | P value | |
|---|---|---|---|---|---|
| UUC-10 after SDD · 10 days · log-rank test | 11.5% | 10.9% | Not reported in the abstract | P = 0.8 | Control: not reported in the abstract |
| Re-hospitalization | 1.7% | 1.7% | Not reported in the abstract | Control: not reported in the abstract |
- UUC-10 after SDD — Overall UUC-10 66/585
- 11.3%
- Re-hospitalization — Re-hospitalized
- 10
- Re-hospitalization — Haematomas
- 4
- Re-hospitalization — Pericarditis
- 4
- Re-hospitalization — Symptomatic sinus node dysfunction
- 2
Original publication
Clinical and economic outcomes of a systematic same-day discharge programme after pulmonary vein isolation: comparison between cryoballoon vs. radiofrequency ablation. Europace. Published 5 September 2023. doi:10.
Summarised from the published abstract; every number is checked against it