FEASIBILITY, SAFETY AND COST EFFECTIVENESS OF SAME-DAY DISCHARGE FOR CATHETER ABLATION REQUIRING A TRANSSEPTAL PUNCTURE: A FRENCH SINGLE HIGH-VOLUME CENTER EXPERIENCE SAME-DAY DISCHARGE FOR LEFT-SIDED CATHETER ABLATION

Abstract

Background: The number of catheter ablationsrequiring a transseptal puncture is increasing. These procedures
have a significant complication rate that decreased over recentyears. As a result, we have developed a same-day
discharge protocol and this study investigates the safety and efficacy of this protocol.
Methods:This single center study evaluated the complication rate following the index procedure for patients
undergoing left-sided accessory pathway, atrial fibrillation (AF) or left sided premature ventricular contraction
(PVC)ablation using a transseptal puncture with a same-day discharge protocol. In addition, the costeffectiveness of the protocol was evaluated.
Results: From November 2015 to March 2020, 2654 ablations in the left cardiac cavities requiring a transseptal
puncture were performed. Among them, 121 (4.6%) patients followed the same-day discharge protocol. Strict
inclusion criteria (mainly low comorbidities)were applied for patients undergoing AF ablation. We used a single
catheter approach to perform AF and PVC ablation. After 10 days and a specific follow-up, we observed 1
cardiac tamponade (0.8%) and3 arrhythmia recurrences (2.5%). There wereno deaths, local vascular
complications or stroke. The night stay cost of 900€ could be saved for the same-day strategy compared to
conventional care but the global balance was still negative at –917€ for the hospital.