Electrophysiology Fellow Sunnybrook Health Sciences Centre Toronto, Ontario, Canada
Background: Catheter ablation is a well-established treatment for idiopathic premature ventricular complexes (PVCs). As procedural safety continues to improve and healthcare systems face growing demands on inpatient resources, same-day discharge (SDD) strategies are gaining interest as a means to optimize care delivery. However, data comparing outcomes between SDD and overnight admission for idiopathic PVC ablation are limited.
METHODS AND RESULTS: This single-centre retrospective study included 153 patients who underwent idiopathic outflow-tract (OT) PVC ablation at Sunnybrook Health Sciences Centre between 2016 and March 2025. Patients were grouped into SDD (n=47) and non-SDD (n=59) based on their post-procedure disposition. Demographic, procedural, and outcome data were compared using t-tests, Mann–Whitney U, and Fisher’s exact tests. Cohen’s d was used to estimate effect size. The two groups were similar in age (52 vs. 54 years, p=0.29), ejection fraction (55% vs. 53%, p=0.12), sex distribution (49% vs. 53% female, p=0.74), and RVOT PVC origin (74% vs. 66%, p=0.28). Procedure time was not significantly different (158 vs. 176 min, p=0.14), but post-procedural monitoring time was significantly shorter in the SDD group (625 vs. 1117 min, p< 0.0001). Acute procedural success (98% vs. 95%, p=0.65), 30-day ER visits (2.1% vs. 3.4%, p=0.67), and hospital readmissions (0% vs. 1.7%, p=0.45) were not statistically different. Long-term procedural success, defined as PVC burden < 5% between 3 and 12 months post-ablation, was similar (85% vs. 83%, p=0.77).
Conclusion: Same-day discharge following idiopathic PVC ablation is safe and feasible, with comparable clinical outcomes to overnight admission. Significantly reduced hospital monitoring time supports improved operational efficiency. In the context of increasing healthcare demand and constrained resources, SDD pathways may reduce costs and optimize bed utilization without compromising patient outcomes.
