We read with great interest the study by Sam et al. entitled” Immediate Leg Mobilization is Feasible After Catheter Ablation of Atrial Fibrillation Using Large Vascular Access Sheaths (Pulsed Field and Cryoballoon Ablation)” [1](#ref-0001). demonstrating the feasibility of immediate leg mobilization following catheter ablation of atrial fibrillation using suture-mediated vascular closure devices. Their findings of comparable vascular complication rates between immediate mobilization and traditional 4-hour bed rest, coupled with significantly shorter discharge times, address an important clinical question impacting both patient comfort and healthcare efficiency. While we commend this valuable contribution, we wish to highlight two critical considerations that warrant discussion for optimal clinical implementation. A limitation is the lack of systematic bleeding risk stratification in the immediate mobilization protocol. Although the study reports uniform anticoagulation management, it fails to incorporate validated bleeding risk assessment tools such as HAS-BLED scores[2](#ref-0002) or patient-specific factors including renal function, concomitant antiplatelet therapy, and prior bleeding history. In clinical practice, elderly patients with multiple comorbidities, those with recent bleeding episodes, or patients requiring dual antiplatelet therapy represent higher-risk populations who may require modified protocols despite successful vascular closure.Future protocols should integrate validated bleeding risk scores (HAS-BLED, CRUSADE) to guide patient selection and incorporate risk-stratified mobilization timelines, with high-risk patients receiving extended bed rest periods[3](#ref-0003) rather than universal immediate mobilization. The most significant methodological concern involves confounding factors that threaten internal validity. The immediate mobilization protocol implementation in 2024 coincided with institutional adoption of pulsed-field ablation, creating a striking imbalance: 72% of immediate mobilization cases utilized PFA versus only 5% in the bed rest group. Furthermore, the bed rest cohort demonstrated significantly higher comorbidity burden, including greater prevalence of coronary artery disease (36% vs 23%), diabetes (37% vs 17%), and heart failure (35% vs 21%)[1](#ref-0001).Future studies should employ propensity-matched analyses [4](#ref-0004) adjusting for baseline characteristics, conduct procedure-specific subgroup analyses, and ideally implement prospective randomized trials with contemporary matched controls to eliminate temporal confounding. In conclusion, while immediate mobilization appears promising, robust implementation requires individualized bleeding risk assessment and methodologically rigorous studies that isolate the true effect of mobilization strategy from procedural and temporal confounders. These enhancements would provide clinicians with evidence-based guidelines for safe patient selection in this evolving approach to post-procedural care.