Same-Day Discharge in Ventricular Ablation: Safety Outcomes and Case Selection.

INTRODUCTION

Catheter ablation (CA) of ventricular arrhythmias (VA) has traditionally entailed an overnight stay, and little has been published on outcomes of same-day discharge (SDD) in this population. Thus far, no comparative study of SDD in VA ablation has been described.

METHODS

This was a single-center prospective comparative observational study of 255 consecutive patients undergoing elective CA of VA (PVC or VT) in the outpatient setting between April 2023 and June 2025. We excluded patients who were pre-admitted or planned for admission or overnight stays post-ablation. SDD was at the attending physician's discretion. Post-discharge, patients had routine telephone follow-up to monitor for complications.

RESULTS

Among 255 patients undergoing ablation for ventricular arrhythmia, 123 (48%) underwent SDD. Patients undergoing SDD had a mean age of 61 ± 16, 38% were female, 33% had heart failure, and the majority had CA for PVC (96%). Compared with those who stayed overnight, SDD patients had higher EF (50% vs. 46%, p = 0.003), less arterial access (48% vs. 62%, p = 0.02), and lower PAINESD score (3.4 vs. 4.8, p = 0.04). Over 30 days of follow-up, two patients (1.6%) had major access site complications, and one (0.8%). Based upon these observations, we describe favorable characteristics for SDD in CA of VA, with the key features of including low-to-moderate risk patients, early case timing, liberal closure device usage, and close follow-up by a dedicated clinical nurse.

CONCLUSION

SDD is feasible and safe for patients undergoing PVC ablation and potentially a subset of patients undergoing VT ablation.