Background Catheter ablation (CA) is a common treatment for atrial fibrillation (AF). This study evaluated outcomes of same day discharge (SDD) versus overnight stay (ONS) among AF patients undergoing outpatient CA. Methods The Optum SES Clinformatics Extended Data Mart database was used to identify patients ≥18 years of age undergoing outpatient CA for AF (2016–2020). Eligible patients were indexed to the date of first CA and classified into SDD and ONS groups based on the length of service. A 1:3 propensity score matching was used to create comparable SDD:ONS samples. The primary safety outcome was CA‐related complications within 30 days of index procedure. The primary efficacy outcome was AF recurrence within 1 year. Cox proportional hazards models were estimated for outcome comparison. Results In the postmatch 30‐day cohort for safety evaluation, there were 6600 patients (1660 [25.2%] SDD; 4940 [74.8%] ONS), with a mean age of 66.6 years. There was no significant difference in the 30‐day composite rate of postablation complications (4.7% [78/1660] vs. 3.8% [187/4940]; p = 0.100) and 1‐year composite rate of AF recurrence (14.3% [142/996] vs. 14.5% [430/2972]; p = 0.705) between the SDD and ONS groups. Conclusion This study demonstrated that SDD following CA to treat patients with AF is safe, with low rates of postablation complications and AF recurrence, which were comparable to rates in patients with an ONS after CA.

Background As same-day discharge (SDD) after catheter ablation (CA) for atrial fibrillation (AF) is increasingly utilized, it is important to further investigate this approach. Objective To investigate the safety and efficacy of SDD after CA for AF in a large nationwide administrative sample. Methods The IBM MarketScan Commercial Claims and Encounters database was used to identify adult patients under 65 years undergoing CA for AF (2016–2020). Eligible patients were indexed to date of first CA and classified into SDD or overnight stay (ONS) groups based on length of service. A 1:3 propensity score matching was used to create comparable SDD:ONS samples. Study outcomes were CA-related complications within 30 days after index procedure and AF recurrence within 1 year. Cox proportional hazards models were estimated for outcome comparison. Results In the postmatch 30-day cohort, there were 1610 SDD and 4637 ONS patients with mean age 56.1 (± 7.6) years. There was no significant difference in composite 30-day postprocedural complication rate between SDD and ONS groups (2.7% vs 2.8%, respectively; P = .884). The most common complications were cerebrovascular events (0.7% vs 0.7%; P = .948), vascular access events (0.6% vs 0.6%; P = .935), and pericardial complications (0.6% vs 0.5%; P = .921). Further, no significant difference in composite AF recurrence rate at 1 year was observed among SDD and ONS groups (10.2% vs 8.8%; hazard ratio = 1.167; 95% confidence interval 0.935–1.455; P = .172). Conclusion In a large, propensity-matched, real-world sample, SDD appears to be safe and have similar outcomes compared with overnight observation following CA for AF.

Objectives: Analysis of healthcare expenditure of patients with heart failure for 12 months from the time of index admission. Methods: Manipal Heart Failure Registry (MHFR), established in 2015 in a tertiary care hospital in Southern India, is a prospective observational cohort of patients diagnosed with heart failure. From this registry, we analysed the total expense incurred during index hospitalization from in-patient bills which included the consultation charges, expenses for ICU/ward stay, investigations, interventional procedures and medications. Similarly, the expenses incurred for medications, visits and re-hospitalization(s) during the 12 month follow up period were calculated. Results: A total of 610 patients with mean age of 65.0 6 13.6 years were included among which 59.8% were males and 38.9% had ischemic heart failure. Average duration of index hospitalization was 5.3 days with an average expenditure of INR 59492 (V710). This included the charges for hospitalization and consumables [INR 9210.9 (V110)], investigations [INR 6465.0 (V65)], medicines, devices and procedural charges [INR 38940.1 (V461)], consultation/professional charges [INR 2158.2 (V26)] and expenditure incurred by caregivers [INR 2717.8 (V40)]. Follow up data was available for 98.1% of the patients. Re-hospitalization rate was 10.8% and 34.1% patients had unscheduled visits to the hospital due to worsening symptoms. Average expenses during the 12 months follow-up period was INR 22680 (V268) which included re-hospitalizations, scheduled/unscheduled visits, and medications. Patients who were non-compliant to medicines or were re-hospitalized during the follow up period spent considerably more than those who were not [INR 32876 (V387) vs INR 20899 (V247), p= 0.042; INR 35255 (V416) vs INR 20213 (V237), p= 0.002, respectively]. Conclusions: Healthcare expenditure of patients with heart failure in India is much lower than their western counterparts. Hospitalizations and interventional procedures account for bulk of the expenses incurred. Drug non-compliance is an important and easily avoidable cause for increased healthcare expenditure.

in the OSA positive and treated group (72, 55%) and highest in the OSA positive but untreated group (41,100%). Unscreened patients also had high recurrence rate (41,84%) and patients without OSA had the lowest rate of recurrence (6%; Figure 1b, log-rank 46.1, p,0.0001). On multivariable models adjusting for left atrial size, AF type, body mass index, and glycated hemoglobin, compliance with NIPPV was significantly associated with freedom from recurrent arrhythmia (HR 0.38, 95% CI 0.26-0.56, P,0.0001). Conclusion:In morbidly obese patients, preemptive diagnosis and treatment of OSA reduces the rate of arrhythmia recurrence after ablation.