Safety and Cost-Analysis of Same-Day Versus Next-Day Discharge Following Complex Ablation Procedures: A Single-Centre Observational Study

Abstract

(1) Introduction and objectives: The most common practice after a complex ablation procedure (CAP) is next-day discharge (NDD) following an appropriate observation period. However, the use of same-day discharge (SDD) has increased substantially since the COVID-19 pandemic. We aimed to evaluate the safety and cost-analysis of an SDD strategy for patients undergoing CAP. (2) Methods: This was a single-centre, retrospective observational study of patients undergoing CAP between January 2021 and July 2024, with intracardiac echocardiography used in all procedures. (3) Results: A total of 250 CAPs were performed, with a complication rate of 20.4% in the initial cohort. Forty-five patients were excluded, mainly because of significant procedural complications or severe pre-ablation medical conditions. The final analysis included 205 patients: 70 in the SDD group and 135 in the NDD group. Multiple patient and procedural characteristics were evaluated and compared between the groups. Among patients included in the final analysis, the overall complication rate was low (8.8%), with no differences between groups (early minor complications, 5.4%: 8.6% vs. 3.7% for SDD vs. NDD, p = 0.191; late major complications, 0.5%: 0% vs. 0.7%, p = 1; late minor complications, 3.4%: 2.9% vs. 3.7%, p = 1). There were five deaths (2.4%), none of which were procedure related. The SDD policy for CAP during this period would have saved €479.84 ± €248.09 per patient. (4) Conclusions: An SDD strategy was feasible and cost-saving and seemed to not increase periprocedural complications compared with an NDD strategy.