Pulmonary Vein Isolation for Treatment of Atrial Fibrillation Performed as a Day Procedure: A Five Year Single Centre Experience

Introduction: Pulmonary vein isolation procedures (PVI) are undertaken with curative intent in patients with drug-refractory atrial fibrillation. Traditionally this has required an inpatient hospital stay for a minimum of two days based on the expectation that most complications arise within the first 24 h. Day procedure PVI has been performed within Monash Medical Centre, Clayton since 2007. There is no published data on the safety and efficacy of “day case” pulmonary vein isolation (PVI) in Australia. Methods: A retrospective case review was performed from the period of January 2007–February 2012 through medical records and procedural database (Cardiobase). Results: There were 141 PVI studies performed at Monash Medical Centre in this period with 23 performed as day case procedures. Of these, 99 were performed using wide-area circumferential ablation with radiofrequency energy and 42 utilised the cryoballoon technique. Procedural success was defined as electrical isolation of the pulmonary veins and was achieved in 100% of day cases and 94 of 94 pulmonary veins treated. All patients were monitored for a minimum period of 4 h. Post-procedure inpatient admission was required in two patients. Major complications (death) occurred in one patient intra-operatively. All complications were identified in patients prior to their planned discharge. Conclusion: Day case PVI is a safe and efficacious alternative to inpatient PVI.