The feasibility of same-day discharge for the epicardial component of convergent hybrid ablation
O Ahmed, A Momin, R A KabaAbstract
Introduction
Convergent hybrid epicardial-endocardial ablation (HA) is an effective rhythm-control strategy for patients with persistent atrial fibrillation (AF). The epicardial surgical stage conventionally requires overnight hospital admission, and data on the feasibility of planned same-day discharge following this procedure are limited.
Methods
We performed a retrospective analysis of patients undergoing the epicardial stage of HA via a minimally invasive posterior pericardioscopic approach under general anaesthesia, with same-day discharge planned. Baseline characteristics, procedural outcomes, and peri-procedural complications were assessed. Primary endpoints were feasibility, defined as successful procedural completion with same-day discharge, and safety, defined as the absence of major complications or unplanned readmissions within 30 days.
Results
Twenty patients were included (80% male; mean age 66.6 ± 8.4 years; mean BMI 28.2 ± 4.0 kg/m²). AF phenotype included persistent AF (55%), recurrent persistent AF (25%), and long-standing persistent AF (20%), with a mean AF duration of 15.9 ± 15.4 months. The mean left ventricular ejection fraction was 37.0 ± 7.7%, and the mean left atrial volume index was 55.8 ± 10.1 mL/m². All procedures were completed successfully, and all patients achieved planned same-day discharge. There were no major complications or unplanned readmissions at 30-day follow-up. One patient developed a superficial wound infection, which resolved with oral antibiotic therapy.
Consusion
In this selected cohort, planned same-day discharge following the epicardial stage of Convergent hybrid ablation was feasible and associated with a low complication burden. These findings support further prospective evaluation of day-case pathways for hybrid AF ablation.Same-Day Discharge (Epicardial Ablation)