Same-day discharge after catheter ablation gains backing from top cardiology societies

Editor's Note

Same-day discharge following catheter ablation is both safe and increasingly standard in appropriately selected patients, according to a new joint scientific statement from the Heart Rhythm Society and the American College of Cardiology, TCTMD April 24 reports. The statement reflects growing evidence and clinical experience suggesting that, with proper patient selection and adherence to protocol, many individuals can safely return home the same day—saving costs and expanding access without sacrificing outcomes.

As detailed in the article, the statement outlines principles to guide implementation of same-day discharge protocols. Historically, patients stayed overnight after ablation procedures due to concerns about periprocedural complications. However, national data show a sharp rise in same-day discharge, particularly after the onset of the COVID-19 pandemic. Between 2016 and mid-2023, same-day discharge rates for atrial fibrillation ablation rose from about 1% to 62% among centers in the National Cardiovascular Data Registry. Complication rates remained low: 0.19% overall and 0.03% major for same-day patients, compared to 0.98% and 0.24%, respectively, for those hospitalized overnight.

The statement emphasizes that procedural advancements and improved patient outcomes have made same-day discharge more feasible, particularly for simpler arrhythmias such as atrioventricular nodal reentrant tachycardia and focal atrial tachycardias. Atrial fibrillation cases, which are more complex, require more selective use of the strategy. Patient eligibility factors include stable comorbid conditions, adequate home support, and geographic proximity to the treating facility. A checklist and guidance on shared decision-making are included to ensure safety and respect for patient preferences.

Electrophysiologist oversight is central to the protocol’s safety, with physicians tasked with determining discharge suitability, noted co-author Samuel Jones, MD, in the article. The statement also lays the groundwork for future guidance on performing ablations in ambulatory surgery centers (ASCs), which are increasingly being used for lower-complexity EP procedures. While ASCs were the initial focus of the writing committee, the societies prioritized issuing a framework for same-day discharge first. Upcoming documents will address safety and quality tracking specific to ASCs.