Burden of arrhythmia and electrophysiologic procedures in alcoholic cardiomyopathy hospitalizations

Authors

Samian Sulaiman
Nazdar Yousef
Mina M Mehanni
Sakthi Sundararajan
Romina Wingert
Michael Wingert
Asim Mohammed
Arshad Jahangir, Advocate Aurora HealthFollow

Recommended Citation

Sulaiman S, Yousef N, Mehanni MM, et al. Burden of arrhythmia and electrophysiologic procedures in alcoholic cardiomyopathy hospitalizations. Int J Cardiol. 2020; 304:61-68. doi: 10.1016/j.ijcard.2020.01.068.

Affiliations

Aurora Cardiovascular Services, Aurora Sinai/Aurora St. Luke's Medical Centers

Abstract

BACKGROUND: Limited national US data are available regarding the prevalence of and trends in different arrhythmias and the use of electrophysiological procedures in patients with alcoholic cardiomyopathy.

METHODS: This was a cross-sectional study that used the Nationwide Inpatient Sample database (2007-2014). Hospitalizations of adults with alcoholic CMP were identified with the ICD-9 code (425.5). CAD and other causes of cardiomyopathy were excluded. Chi-square test, t-test, mixed-effect logistic regression and quantile regression were used.

RESULTS: Among 75,430 hospitalizations, 48% had arrhythmias. Individuals with a co-diagnosis of arrhythmia tended to be older (56.9 vs 53.2-year-old) and male (89.5% vs 81.9%). The most prevalent arrhythmias were atrial fibrillation/flutter (31.5%), followed by ventricular tachycardia (7.9%). The prevalence of arrhythmias increased from 44% to 50% (2007-2014) (p < 0.001) and this increase was mainly secondary to the increasing prevalence AFib/AFL. Excluding cardiac arrest, arrhythmias were not associated with increased in-hospital mortality. The median length of stay and total charges for arrhythmia vs no-arrhythmia hospitalizations were 5 vs 4 days (p < 0.001) and $31,127 vs $24,199 respectively (p < 0.001). EP procedures were performed in 5.6% of all hospitalizations and it increased from 5.2% to 6% (2007-2014) (p = 0.2). The most common procedures were cardioversion (2.7%), ICD placement (2.2%) and PPM placement (1.1%).

CONCLUSION: Arrhythmias were reported in 48% of hospitalizations. There was an increasing burden of arrhythmias secondary to increasing atrial fibrillation. Excluding cardiac arrest, arrhythmias were not associated with increased in-hospital mortality but were associated with longer hospital stays and higher total charges.

Document Type

Article

PubMed ID

32057474