Affiliations

Aurora St. Luke's Medical Center, Aurora Sinai Medical Center

Abstract

Background/Significance:

Pulsed field ablation (PFA) is a novel modality for atrial fibrillation (AF) ablation that has demonstrated favorable safety outcomes compared with thermal modalities. While same-day discharge (SDD) after catheter ablation is common given the benefits to patient comfort as well as decreased utilization of hospital resources, evidence showing the safety of standardized SDD protocols following PFA compared with overnight hospitalization remains limited. This study evaluated the safety, recurrence, and procedural outcomes of PFA with SDD in a real-world population at one center.

Purpose:

The purpose of this study is to evaluate the safety and feasibility of SDD following PFA for AF in a real-world U.S. practice by assessing procedural outcomes and complications.

Methods:

We retrospectively analyzed 78 consecutive patients who underwent PFA for paroxysmal (n=53, 68.0%) or non-paroxysmal (n=25, 32.0%) AF from March to July 2024 and were discharged to home the same day as the procedure. We examined a follow-up window of 30 days. Continuous variables are presented as median (Q1, Q3) or mean ± standard deviation.

Results:

Among the 78 patients undergoing PFA, median age was 65.6 years and 24.4% were female. The median CHA₂DS₂-VASc score was 2.0 (1.0, 3.0). Most procedures were performed under general anesthesia 72 (92.3%). All had uninterrupted anticoagulation. Vascular closure was achieved with either figure-of-eight suture 37 (47.4%) or mechanical closure device 41 (52.6%) with a median bed rest time of 6.0 (4.0, 6.0) hours. There were no cardiac or procedure-related deaths and no vascular complications, pericardial effusions, or strokes. Early arrhythmia recurrence within 30 days was observed in 8 (10.3%) patients. 30-day readmission occurred in 4 (5.1%) patients with two due to AF recurrence and two for non-procedural causes, one for NSTEMI and one for dizziness without AF.

Conclusion:

SDD following PFA appears to be a safe and feasible strategy in real-world practice, with low complication and readmission rates. The encouraging outcomes across many variables highlight the potential of PFA to support implementation of SDD pathways. Further prospective, randomized studies are needed to determine which patient populations, if any, would not be suitable candidates.

Presentation Notes

Presented at Scientific Day; May 20, 2026; Milwaukee, WI.

Full Text of Presentation

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Poster


 

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May 20th, 12:00 AM

Review of Same-Day Discharge Following Pulsed Field Ablation for Atrial Fibrillation

Background/Significance:

Pulsed field ablation (PFA) is a novel modality for atrial fibrillation (AF) ablation that has demonstrated favorable safety outcomes compared with thermal modalities. While same-day discharge (SDD) after catheter ablation is common given the benefits to patient comfort as well as decreased utilization of hospital resources, evidence showing the safety of standardized SDD protocols following PFA compared with overnight hospitalization remains limited. This study evaluated the safety, recurrence, and procedural outcomes of PFA with SDD in a real-world population at one center.

Purpose:

The purpose of this study is to evaluate the safety and feasibility of SDD following PFA for AF in a real-world U.S. practice by assessing procedural outcomes and complications.

Methods:

We retrospectively analyzed 78 consecutive patients who underwent PFA for paroxysmal (n=53, 68.0%) or non-paroxysmal (n=25, 32.0%) AF from March to July 2024 and were discharged to home the same day as the procedure. We examined a follow-up window of 30 days. Continuous variables are presented as median (Q1, Q3) or mean ± standard deviation.

Results:

Among the 78 patients undergoing PFA, median age was 65.6 years and 24.4% were female. The median CHA₂DS₂-VASc score was 2.0 (1.0, 3.0). Most procedures were performed under general anesthesia 72 (92.3%). All had uninterrupted anticoagulation. Vascular closure was achieved with either figure-of-eight suture 37 (47.4%) or mechanical closure device 41 (52.6%) with a median bed rest time of 6.0 (4.0, 6.0) hours. There were no cardiac or procedure-related deaths and no vascular complications, pericardial effusions, or strokes. Early arrhythmia recurrence within 30 days was observed in 8 (10.3%) patients. 30-day readmission occurred in 4 (5.1%) patients with two due to AF recurrence and two for non-procedural causes, one for NSTEMI and one for dizziness without AF.

Conclusion:

SDD following PFA appears to be a safe and feasible strategy in real-world practice, with low complication and readmission rates. The encouraging outcomes across many variables highlight the potential of PFA to support implementation of SDD pathways. Further prospective, randomized studies are needed to determine which patient populations, if any, would not be suitable candidates.

 

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