Three-Hour Bedrest and Same-Day Discharge After Atrial Fibrillation Ablation

Researchers, led by Benjamin L. Freedman, examined the risks and benefits of same-day discharge or shortened bedrest after ablation for atrial fibrillation in patients undergoing hemostasis with the figure-of-eight (FO8) suture technique. Their article, published in the Journal of Interventional Cardiac Electrophysiology, reported that same-day discharge after three hours of bedrest was safe and feasible.

Furthermore, same-day discharge and shortened bedrest was not associated with an increased rate of complications or rehospitalizations after 30 days. Notably, “reduced bedrest resulted in decreased opioid analgesia and urinary catheterization,” according to the investigators.

The investigators assessed access site bleeding, length of hospitalization, urinary catheterization, and other clinical outcomes in patients undergoing atrial fibrillation ablation. Ninety-four patients were enrolled to a three-hour bedrest group and compared to 118 patients who underwent a six-hour bedrest protocol.

According to the article, same-day discharges were achieved by 74% of patients in the three-hour bedrest group compared to 7% of patients in the six-hour bedrest group (p <0.001). No differences were observed between the groups in rate of serious adverse event (2% vs. 1%; p = 0.45), or in rehospitalizations and emergency department visits (1% vs. 3%; p = 0.45) in the month following ablation. While the three-hour bedrest group showed a numerical trend toward more access site bleeding (15% vs. 8%; p = 0.10), the group had significant reductions in urinary catheterization (27% vs. 64%; p <0.001) and opioid analgesia use (20% vs. 33%; p = 0.04).

Ultimately, the study’s findings supported the favorable conclusions from initial studies on a shortened bedrest and same-day discharge approach among patients undergoing hemostasis with FO8 sutures after atrial fibrillation ablation.