title: Same-day cardiac catheter ablation is safe and cost-effective: Experience from a UK tertiary center.
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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Cardiology, University Hospital Coventry/Warwick Medical School, Coventry, United Kingdom.
authors.forename: Mark D
authors.initials: MD
authors.lastname: Theodoreson
authors.affiliation: Department of Cardiology, University Hospital Coventry/Warwick Medical School, Coventry, United Kingdom.
authors.forename: Bhaveek C
authors.initials: BC
authors.lastname: Chohan
authors.affiliation: Department of Cardiology, University Hospital Coventry/Warwick Medical School, Coventry, United Kingdom.
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: McAloon
authors.affiliation: Department of Cardiology, University Hospital Coventry/Warwick Medical School, Coventry, United Kingdom.
authors.forename: Amritpal
authors.initials: A
authors.lastname: Sandhu
authors.affiliation: Department of Cardiology, University Hospital Coventry/Warwick Medical School, Coventry, United Kingdom.
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Lancaster
authors.affiliation: Good Hope Hospital, Birmingham, United Kingdom.
authors.forename: Shamil
authors.initials: S
authors.lastname: Yusuf
authors.affiliation: Worcester Royal Hospital, Worcester United Kingdom.
authors.forename: William
authors.initials: W
authors.lastname: Foster
authors.affiliation: Department of Cardiology, University Hospital Coventry/Warwick Medical School, Coventry, United Kingdom. Electronic address: faizel.osman@btinternet.com.
authors.forename: Faizel
authors.initials: F
authors.lastname: Osman
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001145:Arrhythmias, Cardiac / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D062906:Cardiac Catheters / Q000009:adverse effects / Q000191:economics / Q000706:statistics & numerical data; D017115:Catheter Ablation / Q000009:adverse effects / Q000191:economics / Q000379:methods / Q000401:mortality; D003362:Cost-Benefit Analysis / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
keywords: Cost efficacy; Health care economics; Safety; Same-day catheter ablation