Same day discharge can be performed safely after atrial fibrillation catheter ablation using a wide-footprint lattice-tip dual-energy system

Background Same day discharge (SDD) after atrial fibrillation (AF) ablation is generally considered safe, since most complications are identified during (or immediately) after the procedure. Objective To evaluate SDD in the SPHERE Per-AF trial. Methods Persistent AF patients were randomized to the dual-energy lattice-tip mapping and ablation catheter (investigational) vs. a conventional contact force radiofrequency ablation system (control). SDD and timing of 30-day procedure- or device-related serious adverse events (SAEs) were assessed in the full cohort. In a subset of centers that performed SDD in the trial, predictors of SDD, 30-day readmissions, and mortality rates were assessed. Results SDD was achieved in 229 of 418 (54.8%) patients (55.9% of investigational (n=211) and 53.6% of control (n=207; p=0.64)). Of the remaining patients, 181 (43.3%) were discharged the next day, while 8 (1.9%) were discharged 2-7 days post-ablation. A total of 11 of 14 procedure- or device-related SAEs occurred within the first 3 days post procedure, with no relevant difference between SDD and overnight stay. In a subset of 14 centers with at least one SDD in the trial, procedure duration, procedure end time and race predicted overnight stay (all p