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Peer-reviewedCC BY 4.0Journal of Interventional Cardiac Electrophysiology

Same-day discharge versus overnight stay after catheter ablation for atrial fibrillation: a systematic review and meta-analysis

  • Martín Rebolledo Del Toro1,2
  • Maria Alejandra Robledo Gomez2
  • Oscar Mauricio Muñoz-Velandia2,3
  • Juan Felipe Betancourt Rodriguez1,2,3
  1. 1Division of Electrophysiology, Hospital Universitario San Ignacio, Bogota, Colombia
  2. 2Department of Internal Medicine, Pontificia Universidad Javeriana, Bogota, Colombia
  3. 3Department of Internal Medicine, Hospital Universitario San Ignacio, Bogota, Colombia
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Abstract

Background: The safety of same day discharge after atrial fibrillation ablation remains uncertain because prior evidence relied mainly on heterogeneous observational studies with limited control of confounding. This systematic review and meta-analysis compared structured same day discharge with overnight stay.

Methods: We searched MEDLINE, Embase, Web of Science, Scopus, CENTRAL, Epistemonikos and LILACS from 1994 to May 2025 for randomized and nonrandomized controlled studies of adults undergoing atrial fibrillation ablation with pulmonary vein isolation. Comparisons were protocolized same day discharge versus overnight hospitalization. Outcomes were all-cause mortality, short term (30-day) unplanned medical contact (readmissions or emergency visits), and procedural complications. Random-effects models generated pooled odds ratios (ORs) with 95% confidence intervals.

Results: Nineteen studies (26,335 patients) met inclusion criteria, including two randomized trials and seventeen non-randomized studies. Same day discharge success averaged 89% across structured programs. Mortality was rare in both groups, and pooled mortality did not differ between strategies. At 30 days, same day discharge was not associated with excess of readmission or emergency department visits and the pooled estimate favored same day discharge (OR 0.63; 95% CI 0.51–0.78; I2 0%). Complication rates were low in both groups, although definitions varied. Most non-randomized studies had moderate to serious risk of bias.

Conclusion: Structured same day discharge after atrial fibrillation ablation shows no evidence of increased mortality, major complications, or unplanned healthcare use in selected outpatients. Implementation should rely on explicit eligibility criteria and early follow up. Further randomized trials are required to establish safety in higher-risk populations and to evaluate the safety of newer ablation technologies.

Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s10840-026-02286-x.

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Cite

BibTeXRIS
BibTeX
@article{toro2026sameday,
  title = {{Same-day discharge versus overnight stay after catheter ablation for atrial fibrillation: a systematic review and meta-analysis}},
  author = {Martín Rebolledo Del Toro and Maria Alejandra Robledo Gomez and Oscar Mauricio Muñoz-Velandia and Juan Felipe Betancourt Rodriguez},
  journal = {Journal of Interventional Cardiac Electrophysiology},
  year = {2026},
  month = may,
  doi = {10.1007/s10840-026-02286-x},
  url = {https://doi.org/10.1007/s10840-026-02286-x},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Same-day discharge versus overnight stay after catheter ablation for atrial fibrillation: a systematic review and meta-analysis
AU  - Martín Rebolledo Del Toro
AU  - Maria Alejandra Robledo Gomez
AU  - Oscar Mauricio Muñoz-Velandia
AU  - Juan Felipe Betancourt Rodriguez
PY  - 2026
DA  - 2026/05/18
JO  - Journal of Interventional Cardiac Electrophysiology
DO  - 10.1007/s10840-026-02286-x
UR  - https://doi.org/10.1007/s10840-026-02286-x
AB  - Background: The safety of same day discharge after atrial fibrillation ablation remains uncertain because prior evidence relied mainly on heterogeneous observational studies with limited control of confounding. This systematic review and meta-analysis compared structured same day discharge with overnight stay.  Methods: We searched MEDLINE, Embase, Web of Science, Scopus, CENTRAL, Epistemonikos and LILACS from 1994 to May 2025 for randomized and nonrandomized controlled studies of adults undergoing atrial fibrillation ablation with pulmonary vein isolation. Comparisons were protocolized same day discharge versus overnight hospitalization. Outcomes were all-cause mortality, short term (30-day) unplanned medical contact (readmissions or emergency visits), and procedural complications. Random-effects models generated pooled odds ratios (ORs) with 95% confidence intervals.  Results: Nineteen studies (26,335 patients) met inclusion criteria, including two randomized trials and seventeen non-randomized studies. Same day discharge success averaged 89% across structured programs. Mortality was rare in both groups, and pooled mortality did not differ between strategies. At 30 days, same day discharge was not associated with excess of readmission or emergency department visits and the pooled estimate favored same day discharge (OR 0.63; 95% CI 0.51–0.78; I2 0%). Complication rates were low in both groups, although definitions varied. Most non-randomized studies had moderate to serious risk of bias.  Conclusion: Structured same day discharge after atrial fibrillation ablation shows no evidence of increased mortality, major complications, or unplanned healthcare use in selected outpatients. Implementation should rely on explicit eligibility criteria and early follow up. Further randomized trials are required to establish safety in higher-risk populations and to evaluate the safety of newer ablation technologies.  Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s10840-026-02286-x.
SN  - 1383-875X
SN  - 1572-8595
ER  -