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Arrhythmias & electrophysiologyCohort study

Clinical and economic outcomes of a systematic same-day discharge programme after pulmonary vein isolation: comparison between cryoballoon vs. radiofrequency ablation

EuropacePublished

  • Prospective cohort study
  • single-centre
  • consecutive procedures
  • historical control
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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

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

OutcomeCRYORFControlP value
UUC-10 after SDD · 10 days · log-rank test11.5%10.9%Not reported in the abstractP = 0.8
Re-hospitalization1.7%1.7%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:10.1093/europace/euad265
Read the original article ↗PubMedCite RIS · BibTeX

Summarised from the published abstract; every number is checked against it