HRS/ACC Scientific Statement: Guiding Principles on Same-Day Discharge for Intracardiac Catheter Ablation Procedures.

Abstract

Percutaneous catheter ablation in interventional cardiac electrophysiology has evolved over the past several decades. Technologic advances and evolving procedural strategies have improved procedural efficiencies, increased success rates, and lowered complication rates. These advances have increased the ability to treat more patients successfully; however, limitations to access have grown. Access challenges (exacerbated during the COVID-19 public health emergency) and economic pressures have driven a shift in practice trends to reduce hospitalization duration and optimize resource utilization. A same-day discharge (SDD) strategy has increasingly been used to address these challenges. Incorporating a SDD strategy has recently been supported by global clinical studies (demonstrating proof of concept) and real-world evidence/United States Centers for Medicare & Medicaid Services claims data (characterizing a low incidence of complications and need for readmission/emergency department visits). This document analyzes available global clinical data and real-world evidence examining the impact of a cardiac ablation SDD strategy on patient safety, patient access, operational efficiencies, and health care expenditures. Recommended best practices will also be characterized built on the foundation of a shared decision-making strategy that optimizes patient safety, comfort, and procedural outcomes. As clinical flow paradigms evolve with alternate sites of care (ie, ambulatory surgery centers), real-world registries to track outcomes should inform future decision-making.