Comparison of 30-day readmission and same-day discharge rates in patients undergoing pulsed field vs radiofrequency ablation for atrial fibrillation: A multicenter analysis

Background: Pulsed field ablation (PFA) for atrial fibrillation (AF) is noninferior to radiofrequency ablation (RFA) regarding efficacy. However, data on readmission rates have not yet been compared. Objective: This study aimed to compare rates of 30-day readmission, same-day discharge (SDD), and cardiac- or procedure-related readmissions among patients undergoing PFA vs RFA for AF. Methods: We conducted a multicenter prospective analysis of patients undergoing PFA and RFA for AF in 2024 among 7 hospitals. The primary endpoint was the 30-day readmission rate. The secondary endpoints were rates of SDD and 30-day readmissions owing to cardiac- or procedure-related causes. Results: Among 697 patients, 345 underwent RFA and 352 PFA. Patients undergoing PFA had lower 30-day readmission rate (4.5% vs 11.0%, P = .002), higher SDD rate (80.4% vs 57.7%, P < .001), and lower cardiac- or procedure-related reasons for 30-day readmission (3.1% vs 8.4%, P = .0046), whereas noncardiac-related reasons were comparable in both (2.6% in RFA vs 1.4% in PFA, P = .396). Conclusion: Ablation with PFA was associated with a significantly lower 30-day readmission rate, higher SDD rate, and a lower rate of cardiac-related readmissions than RFA. These findings have implications for health care costs, while reinforcing the safety and tolerability of PFA.