Safety and efficacy of catheter ablation for atrial fibrillation in an ambulatory day surgery center outside the hospital setting.

Abstract

Background: The increasing demand for atrial fibrillation (AF) ablation, coupled with reduced inpatient hospital beds, presents challenges for health care providers, with limited data on the safety and efficacy of performing AF ablation in an ambulatory day surgery center (ADSC) outside the hospital walls. Objective(s): This study aimed to assess the safety and feasibility of catheter ablation for AF in an ADSC in a non-hospital setting. Method(s): A retrospective review was conducted over 4 years of all consecutive patients who underwent catheter ablation at a newly established ADSC. Eligibility criteria included body mass index <45 and undergoing either first-time pulmonary vein isolation (PVI) or redo PVI/atrial tachycardia ablation. Procedures were performed under general anesthesia with transesophageal echocardiography-guided transseptal puncture. Result(s): A total of 450 patients underwent AF ablation, with a median age of 61 years (54-69), and 95% were undergoing their first AF ablation. Cryoballoon ablation was performed in 350 patients (78%), and 80% had paroxysmal AF. The median procedure duration was 58 (50-70) minutes, with successful PVI achieved in all cases. Two patients required same-day hospital transfer but were managed conservatively. The overall acute procedural adverse events rate was 1.2%, with no cases of tamponade or major complications requiring intervention. Three patients (0.6%) required medical attention within 30 days postprocedure. Conclusion(s): Our large single-center experience represents the first report in Europe, demonstrating that AF catheter ablation in an ADSC is both safe and feasible. These results suggest that, with standardized protocols and the development of "one size fits all" technologies, this approach could see broader adoption. Copyright © 2025 Heart Rhythm Society