Same Day Discharge Versus Overnight Stay
At the end of each procedure, patients were observed in a bed-side
waiting room setting (e.g ., critical care unit or intensive care
unit). The operator made the decision for SDD immediately after the
procedure but patient’s discharged status could be changed during
recovery. All patients were observed for acute indications of
pericardial effusion or cardiac tamponade; if either complication was
suspected, a chest x-ray or transthoracic echocardiogram was utilized to
triage the patient. The occurrence of either event nullified the
potential for SDD consideration. Each hospital utilized an
individualized checklist of criteria that were mandatory before a
patient was considered for SDD (Table 1), and importantly, each
patient had to agree to a SDD preference with adequate arrangements for
“secure-to-home” transportation. At each hospital, the nursing staff
and treating physician provided detailed instructions on next-day care
to all patients with a SDD. If SDD was used, the patient was discharged
from the hospital within 6-hours of the procedure and before an
overnight stay was recorded. Patients in the overnight cohort were
discharged via normal and typical next-day standard-of-care policies,
which included a review of patient status during the observational
period. Similarly, each hospital used an individualized checklist of
next-day discharge requirements, and these criteria are also provided
for each hospital (Table 1). Each procedure was performed on
uninterrupted anticoagulation and patients maintained anticoagulation
therapy for a minimum of 60 days after the index ablation.