Safety and feasibility of same-day discharge in patients receiving pulmonary vein isolation—systematic review and a meta-analysis

Purpose: The purpose of this systematic review and meta-analysis was to evaluate the feasibility and safety of a same-day discharge protocol following pulmonary vein isolation (PVI). Methods: PubMed and Embase were systematically investigated from the inception to 20 July 2020. Studies on safety and feasibility of PVI for atrial fibrillation (AF) were included. Study-specific estimates were combined using one-group meta-analysis with a random-effects model. Results: Seven observational studies investigating the safety and feasibility of same-day discharge protocols were identified. Of a total of 3656 patients who have undergone PVI for AF, the overall complication rate was 0.80% (95% confidence interval [CI], 0.20–1.40%). The readmission within 30-day following same-day discharge protocol occurred at a pooled rate of 3.6% (95% CI, 0.0–8.4%). Frequent complications following the procedure were complications related to vascular access (0.38%; 95% CI, 0.18–0.58%), and phrenic nerve injury (0.19%; 95% CI, 0.05–0.33%). The reported complications in SDD group were mainly based on results among patients without perioperative complications. Conclusions: The introduction of same-day discharge strategies might be safe and feasible in selected patients given the reported complication and re-admission rates in the current practice. Further prospective studies are needed to confirm these findings.