Safety of Same-Day Discharge Following Pulsed-Field Ablation Versus Radiofrequency Ablation: A Comparative Analysis.

IF 1.3
Pacing and clinical electrophysiology : PACE Pub Date : 2025-08-01 Epub Date: 2025-07-31 DOI:10.1111/pace.70005
Adele Watfa, Arwa Younis, Mohamad Mdaihly, Joe Demian, Chadi Tabaja, Pasquale Santangeli, Bryan Baranowski, Hiroshi Nakagawa, Tyler Louis Taigen, Koji Higuchi, Thomas D Callahan, Shady Nakhla, Mohamed Kanj, Mina K Chung, Jakub Sroubek, Justin Z Lee, Mandeep Bhargava, Walid I Saliba, Oussama M Wazni, Ayman A Hussein
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引用次数: 0

Abstract

Background: Same-day discharge (SDD) after catheter ablation is increasingly adopted to improve patient convenience and reduce healthcare costs. While SDD following radiofrequency ablation (RFA) is well-documented, no data exist on SDD in patients undergoing pulsed-field ablation (PFA) for atrial fibrillation (AF).

Objective: To evaluate the safety of SDD in patients undergoing PFA and RFA for AF, with an exploratory comparison of practice patterns and outcomes.

Methods: From a prospectively maintained registry, we included all consecutive patients undergoing PFA for AF (FARAWAVE catheter) since its FDA approval and patients undergoing AF RFA between March and October 2023 (comparison group). Outcomes included rates of major complications (vascular complications, cerebrovascular accidents, transient ischemic attacks (TIA), phrenic nerve injury, and pericardial effusion requiring intervention), minor complications, readmissions within 30 days, and all-cause mortality.

Results: The study included 955 PFA patients, of whom 207 (21.7%) were discharged the same day, and 1072 RFA patients, of whom 127 (11.8%) were discharged the same day. Vascular closure modalities differed significantly across groups (p < 0.001). Major complications, including stroke and TIA, occurred in 0.5% of PFA non-SDD and 1.1% of RFA non-SDD patients (p = 0.29, p = 0.24), with no major complications in SDD groups and no deaths across all groups. Minor complications were 0.5% for PFA SDD versus 1.1% for PFA non-SDD (p = 0.44) and 1.6% for both RFA SDD and RFA non-SDD (p = 0.99), and not significantly different between PFA SDD and RFA SDD (p = 0.31). Readmission rates (UTI, AF, aspiration pneumonia) were similar between SDD patients at 1.4% for PFA and 2.4% for RFA (p = 0.54). A lower CHA2DS2-VASc score predicted the practice pattern of SDD in the PFA cohort (OR = 0.754, 95% CI: 0.663-0.858, p < 0.001), while being octogenarian reduced the likelihood of SDD (OR = 0.265, 95% CI: 0.105-0.666, p = 0.005).

Conclusion: In this cohort, SDD was found to be a safe and viable option for both PFA and RFA. In this practice, the rates of same-day discharge were higher in the PFA group versus the RFA group and is being increasingly adopted.

脉冲场消融与射频消融后当日放电的安全性:比较分析。
背景:导管消融后当日出院(SDD)越来越多地被采用,以提高患者的便利性和降低医疗成本。虽然射频消融(RFA)后的SDD有很好的文献记载,但没有关于心房颤动(AF)患者接受脉冲场消融(PFA)后SDD的数据。目的:评价SDD在房颤PFA和RFA患者中的安全性,并对实践模式和结果进行探索性比较。方法:从前瞻性维护的注册表中,我们纳入了自FDA批准以来所有连续接受房颤PFA (FARAWAVE导管)的患者和2023年3月至10月期间接受房颤RFA的患者(对照组)。结果包括主要并发症(血管并发症、脑血管意外、短暂性脑缺血发作(TIA)、膈神经损伤和需要干预的心包积液)、轻微并发症、30天内再入院率和全因死亡率。结果:纳入955例PFA患者,其中207例(21.7%)当天出院;纳入1072例RFA患者,其中127例(11.8%)当天出院。血管关闭方式在各组间差异显著(p结论:在本队列中,SDD被发现是PFA和RFA的安全可行的选择。在这种实践中,PFA组的当日出院率高于RFA组,并且正在越来越多地被采用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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