The Heart Rhythm Society (HRS) and the American College of Cardiology (ACC) have released a joint scientific statement on new guiding principles for same-day discharge (SDD) in patients undergoing intracardiac catheter ablation procedures. This document draws on global clinical data and real-world evidence to evaluate the impact of a cardiac ablation SDD strategy on patient safety, access, operational efficiencies, and healthcare costs. And, according to the HRS and ACC, it also outlines best practises based on a shared decision-making approach designed to prioritise patient safety, comfort and optimal procedural outcomes.
A recent statement from the two organisations notes that, with the increasing prevalence of atrial fibrillation (AF) and the rise in ablation procedures worldwide, access to cardiac electrophysiology (EP) services has “become a growing concern”. Historically, these services have been available primarily through large, specialised centres or healthcare systems, but the increasing adoption of SDD strategies for AF ablation procedures—particularly in ambulatory surgery centres (ASCs)—has introduced new opportunities to improve patient access, reduce healthcare costs, and enhance resource efficiency.
The HRS and ACC therefore emphasise the importance of evidence-based healthcare practices and support the incorporation of SDD strategies in the treatment of AF ablation, as demonstrated by global clinical studies and US claims data from the Centers for Medicare and Medicaid Services (CMS). Real-world evidence—including insights from the COVID-19 pandemic’s Hospitals Without Walls programme—has shown that certain catheter ablation procedures can be safely performed in ASCs. Claims data also suggest that SDD protocols for cardiac ablation may lead to lower complication rates compared to other cardiac procedures already covered by the US CMS.
“This consensus document evaluates global trends and evidence supporting shorter hospitalisation stay with SDD for intracardiac ablations agnostic to site of care,” said Amit Shanker (St Lawrence Health System, Potsdam, USA), vice chair of the HRS Health Policy and Regulatory Affairs Committee, and co-chair of the present document. “With rising demand straining healthcare access, SDD addresses systemic challenges by driving patient availability, and improving operational efficiencies and care quality. By reducing overnight stays and resource utilisation, SDD protocols can lower healthcare costs while maintaining safety, aligning clinical priorities with fiscal sustainability.”
In addition to improving patient safety, an SDD strategy helps reduce out-of-pocket patient costs while also enhancing operational efficiency and resource utilisation. According to the HRS and ACC, this approach offers “significant financial benefits” for both patients and healthcare systems, streamlining care while maintaining high standards of quality and safety.
The organisations’ recent statement goes on to state that successful implementation of a SDD protocol requires considerable facility organisation and logistics that intentionally support close coordination of care with patients and their caregivers. The decision to pursue a SDD strategy should be based upon a shared decision-making process between the patient and physician, with a focus on safety, comfort, and the expected outcomes of the procedure, the statement adds.
“We are very excited for this HRS/ACC statement on SDD for EP ablations. The field of EP continues to evolve due to improved workflows, technological innovations, and procedural advancements,” commented Samuel Jones (Chattanooga Heart Institute, Chattanooga, USA), co-chair of the document. “Fuelled by the COVID pandemic, many centres adopted same-day discharge protocols, which have continued to be refined. A growing body of literature supports this paradigm for patients appropriately selected by the electrophysiologist as safe and effective, as well as patient-centred, while also freeing up necessary resources in the healthcare facility.”
The full document was co-published on 24 April in an online edition of Heart Rhythm and also in JACC: Clinical Electrophysiology.
