Going Home the Same Day After AF Ablation: The Evidence and the Experience

Challenging a longstanding assumption — and what the evidence shows

For many years, AF ablation was associated in patients’ minds with a hospital admission — often an overnight stay, sometimes two nights, with all the disruption and anxiety that brings. When I began developing the day-case AF ablation programme at OneWelbeck Heart Health, the question I was most frequently asked by colleagues was: is it safe?

I am pleased to say that we now have a definitive answer — and it is published. In 2025, our team published data from 450 consecutive patients who underwent AF catheter ablation in our ambulatory day surgery centre at One Welbeck Heart Health. The paper appeared in the journal Heart Rhythm (Kanthasamy V, Finlay M, Lim PB et al., Heart Rhythm 2025;22(8):1935–1945), with a group comprising London’s best and most senior electrophysiologists from many several tertiary London centres. We showed that with this protocol, 80% of patients experienced a complete cessation of symptoms and there was a statistically significant reduction in the use of beta blockers, amiodarone and sotalol. Only 12% of patients required a repeat ablation procedure.
The full paper can be found here: https://www.heartrhythmjournal.com/article/S1547-5271(25)00125-0/pdf

What the Study Found

Across 450 consecutive patients over four years, major complication rates were comparable to those reported in large hospital-based series. The vast majority of patients were discharged the same day without complication. Patient satisfaction was high, and the structured same-day post-procedural pathway — including direct telephone follow-up from our specialist nursing team on the day of discharge — was well received by patients and their families.

The cohort had a median age of 61 years; 95% were undergoing their first AF ablation. Procedures were performed under general anaesthesia with transoesophageal echocardiographic guidance, using standard pulmonary vein isolation with advanced three-dimensional mapping. The inclusion of PFA in more recent cases has further streamlined procedural efficiency.

What Does a Day-Case AF Ablation Look Like?

I often find that patients worry about the practical side of the procedure more than the procedure itself. Here is what a typical day looks like at One Welbeck Heart Health:

• You arrive at One Welbeck Heart Health, 1 Welbeck Street, London W1G 0AR, in the morning — typically around 7am
• A pre-procedure assessment is completed: IV access, ECG, brief anaesthetic review
• A transoesophageal echocardiogram confirms there is no clot in the left atrial appendage before we proceed
• The procedure itself, performed under general anaesthesia, takes under 60 minutes
• You are cared for in our post-anaesthesia care unit, typically for three to four hours after the procedure
• Our specialist AF nurse practitioner reviews you before discharge, checking ECG and observations, and provides written and verbal discharge instructions, including groin care management
• Most patients return to light activity within two to three days; full normal activity typically resumes within one to two weeks

This model requires that patients are accompanied home by a responsible adult and not driving for at least 24 hours — the standard requirements following any procedure under general anaesthesia.

Why Does This Matter Beyond Convenience?

Day-case AF ablation is not simply a matter of patient convenience, though the reduction in disruption to working and family life is genuinely significant. It also has broader systemic implications. At a time when NHS bed capacity is under sustained pressure, the availability of high-quality, high-volume AF ablation in an ambulatory private setting like OneWelbeck creates an important safety valve for patients who cannot access timely treatment through the NHS.

For colleagues referring patients — whether GPs or cardiologists — it means that the practical barrier of hospital admission is removed. A patient who has been reluctant to proceed with ablation because of the prospect of an overnight stay often becomes far more willing when same-day discharge is on the table.

The Published Standard

Our 2025 Heart Rhythm paper establishes a published standard of care for day-case AF ablation in the UK. It demonstrates that with the right patient selection criteria, procedural expertise, post-procedural pathway, and facility infrastructure, same-day discharge following AF catheter ablation is safe, effective, and reproducible. We are proud to have contributed this evidence to the field.

To discuss a comprehensive AF management plan, including lifestyle optimisation, book a consultation — drboonlim.co.uk or call 0208 187 9888