Same-day cardiac catheter ablation is safe and cost-effective: experience from a UK tertiary center

Theodoreson, Mark D.; Chohan, Bhaveek C.; McAloon, Christopher J.; Sandhu, Amritpal; Lancaster, Christopher J.; Yusuf, Shamil; Foster, William; Osman, Faizel

doi:10.1016/j.hrthm.2015.05.006

Cited by 28Cardiac Arrhythmias and TreatmentsAtrial Fibrillation Management and OutcomesCardiac electrophysiology and arrhythmias

Same-day cardiac catheter ablation is safe and cost-effective: experience from a UK tertiary center

Theodoreson, Mark D., Chohan, Bhaveek C., McAloon, Christopher J., Sandhu, Amritpal, Lancaster, Christopher J., Yusuf, Shamil, Foster, William, Osman, Faizel·2015·Heart Rhythm

DOI 10.1016/j.hrthm.2015.05.006

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Abstract

Background Catheter ablation is a curative intervention for common arrhythmias such as supraventricular tachycardia and atrial flutter. Many centers still admit patients overnight after this procedure.Objective This study was performed to evaluate the safety and cost-effectiveness of same-day standard catheter ablation.Methods We conducted a retrospective study of all consecutive elective same-day procedures performed between 2010 and 2014. Data were collected on baseline parameters, procedure details and success, postoperative complications, unplanned overnight hospital admissions, and clinical outcome (including mortality) at 4-month follow-up. A cost analysis of potential savings was also performed.Results A total of 1142 patients underwent planned same-day electrophysiological study with or without ablation. Radiofrequency ablation was performed in 897 of these patients (mean age ± standard error 56 ± 0.6 years, range 16-95 years, 467 males), with 921 arrhythmias ablated and with complete procedural success in 883 cases (96%). There were 92 unplanned admissions (10.3%): 50 for concealed pathways that required transseptal puncture, 19 for immediate complications (including 9 femoral bleeds and 5 pacemakers for heart block), 12 admitted at the operator's discretion, and 11 for other clinical reasons. All had transthoracic echocardiography after the procedure, and none had significant pericardial effusion. At 4-month follow-up, there were 16 readmissions (1 deep vein thrombosis, 3 pericarditic chest pain, 2 femoral hematomas, 7 palpitations, and 3 others) and 1 death (unrelated to ablation). An overnight stay at our center costs $450 (£300); same-day ablation over this period saved our institution $365,000 (£240,000).Conclusion Same-day standard catheter ablation is safe and cost-effective, with significant benefits for patients and health care providers. This is particularly important given the current financial climate.

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A retrospective study analysed 1142 patients who underwent elective electrophysiology procedures with or without radiofrequency ablation for supraventricular tachycardia.
“This strategy was analysed in a retrospective study of 1142 patients who underwent elective EP procedures with or without RF ablation for SVT.”
From European Heart Rhythm Association (EHRA) consensus document on the management of supraventricular arrhythmias, endorsed by Heart Rhythm Society (HRS), Asia-Pacific Heart Rhythm Society (APHRS), and Sociedad Latinoamericana de Estimulacion Cardiaca y Electrofisiologia (SOLAECE) (2017) · cites this paper as [418]
Avoidance of overnight stay, with an average cost of $450, resulted in important savings for the institution ($365,000), coupled with a reassuring patient safety profile.
“Avoidance of overnight stay, with an average cost of $450, resulted in important savings for the institution ($365 000), and this was coupled with a reassuring patient safety profile.418”
From European Heart Rhythm Association (EHRA) consensus document on the management of supraventricular arrhythmias, endorsed by Heart Rhythm Society (HRS), Asia-Pacific Heart Rhythm Society (APHRS), and Sociedad Latinoamericana de Estimulacion Cardiaca y Electrofisiologia (SOLAECE) (2017) · cites this paper as [418]

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“Growing evidence shows that SDD following catheter ablation of AF is feasible, safe, and cost-saving [19–22].”
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Use of Satellite-Sites for Percutaneous Cardiac Ablations (the Hub-and-Spoke Model): Lessons From the COVID-19 Pandemic
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“[4] Theodoreson MD, Chohan BC, McAloon CJ, et al.”
Background

Safety and cost-effectiveness of same-day complex left atrial ablation
He, H., Datla, S., Weight, N., Raza, S., Lachlan, T., Aldhoon, B., Panikker, S., Dhanjal, T., Yusuf, S., Foster, W., et al. (2020) · International Journal of Cardiology · doi:10.1016/j.ijcard.2020.09.066 · Cited by 28 · see citing works
Same‐day discharge following catheter ablation of atrial fibrillation: A safe and cost‐effective approach
Creta, A., Ventrella, N., Providencia, R. A., Earley, M. J., Sporton, S. C., Dhillon, G. S., Παπαγεωργίου, Ν., CHOW, A. W. C., Lambiase, P. D., LOWE, M. D., et al. (2020) · Journal of Cardiovascular Electrophysiology · doi:10.1111/jce.14789 · Cited by 57 · see citing works
Safety, Feasibility and Economic Impact of Same-Day Discharge Following Atrial Fibrillation Ablation
Reddy, S. A., Nethercott, S. L., Chattopadhyay, R. K., Heck, P. M., & Virdee, M. S. (2020) · Heart Lung and Circulation · doi:10.1016/j.hlc.2020.02.016 · Cited by 35 · see citing works
Feasibility and Safety of Same-Day Home Discharge After Radiofrequency Catheter Ablation
Marijon, É., Albenque, J., Bovéda, S., Jacob, S., Schmutz, M., Bortone, A. A., Combes, N., & Zimmermann, M. (2009) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2009.03.024 · Cited by 46 · see citing works
P2837Day-case complex left atrial ablation is safe and cost-effective: experience from a UK tertiary centre
Datla, S., Weight, N., Lange, J., Berwick, K., He, H., Lachlan, T., Foster, W., Yusuf, S., Dhanjal, T., Panikker, S., et al. (2019) · European Heart Journal · doi:10.1093/eurheartj/ehz748.1147

Authors: Theodoreson, M. D., Chohan, B. C., McAloon, C. J., Sandhu, A., Lancaster, C. J., Yusuf, S., Foster, W., & Osman, F.
Affiliations: University Hospital Coventry (GB)
Good Hope Hospital (GB)
Worcestershire Royal Hospital (GB)
Corresponding author: Osman, Faizel
ORCID: Theodoreson, Mark D.
McAloon, Christopher J.
Osman, Faizel
Venue: Heart Rhythm
Publisher: Elsevier BV
Published: 2015-08
Volume: 12
Issue: 8
Pages: 1756-1761
ISSN: 1547-5271 (ISSN-L)
DOI: 10.1016/j.hrthm.2015.05.006
OpenAlex: W1502756708
Cited by: 28
References: 11
Citations by year: 2025: 2 · 2024: 2 · 2023: 3 · 2022: 5 · 2021: 5 · 2020: 4 · 2019: 2 · 2018: 2 · 2017: 1 · 2016: 1 · 2015: 1
FWCI: 1.22
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Heart Rhythm (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Arrhythmias and Treatments
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
Keywords: same-day discharge, catheter ablation, radiofrequency ablation, electrophysiological study, cost-effectiveness, procedural safety, postoperative complications, emergency admissions, supraventricular tachycardia, atrial flutter, transseptal puncture, femoral hematoma, atrioventricular block, deep vein thrombosis, pericardial effusion
MeSH terms: Adolescent, Adult, Aged, Aged, 80 and over, Arrhythmias, Cardiac, Cost-Benefit Analysis, Female, Follow-Up Studies, Hospitalization, Humans, Male, Middle Aged, Retrospective Studies, Time Factors, Treatment Outcome, Catheter Ablation, Young Adult, Cardiac Catheters

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Same-day cardiac catheter ablation is safe and cost-effective: experience from a UK tertiary center

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