Suture-Mediated Vascular Closure Improves Same-Day Discharge in Atrial Fibrillation Ablation and Left Atrial Appendage Occlusion.

BACKGROUND: Same-day discharge after atrial fibrillation ablation and left atrial appendage occlusion procedures may improve patient experience, bed availability, and procedural throughput, but prolonged bed rest remains a common operational barrier. PROJECT RATIONALE: We identified the vascular closure strategy and recovery time as modifiable constraints limiting reliable same-day discharge after large-bore femoral venous access. PROJECT SUMMARY: A multidisciplinary team implemented a standardized suture-mediated vascular closure protocol for selected atrial fibrillation ablation and left atrial appendage occlusion procedures. In a retrospective comparison of 139 consecutive cases, suture-mediated closure was associated with shorter time to ambulation, shorter time to discharge, and a higher same-day discharge rate compared with Figure-of-8 closure, without an observed increase in vascular or bleeding complications. TAKE-HOME MESSAGES: Standardized suture-mediated closure may help convert same-day discharge into a predictable operational pathway. Procedural efficiency and patient safety should be measured together.