Abstract 12756: 11 year Trends and Utilization Patterns of Cardiac Implantable Electronic Devices in Patients Diagnosed With Sick Sinus Syndrome
Background: CIEDs (cardiac implantable electronic devices) are commonly used for managing sick sinus syndrome (SSS).
Hypothesis: Compare features of SSS patients (pts) who did and did not receive CIED.
Methods: Pts were identified from the National Inpatient Sample dataset (2003-13). Included pts were ≥18, had a primary diagnosis of sinus node dysfunction and atrial arrhythmia (hence SSS). Pts who died, transferred out or had prior CIED were excluded. Included pts were then stratified by implantation of a CIED. Data regarding SSS and weighted multivariable model of factors associated with CIED implantation are presented.
Results: Over 11 years, 421,535 pts were diagnosed with SSS (mean annual incidence of 38,321 ± 4,258) and the trend for SSS hospitalization fell 19% (p < 0.001). CIED were implanted in 353,247 pts (83.8%) and the annual trend of CIED use was decreasing (p < 0.001). Of 39 variables analyzed, the attached forest plot shows only those variables that were either associated with a lower likelihood (down arrow) or with a higher likelihood (up arrow) for CIED implantation. Lower likelihood for CIED was associated with young age, female, African American race, self-pay, heart failure, COPD, kidney disease, emergency room admission, weekend admission, public/rural/urban nonteaching/small/medium hospitals, midwest/south/west regions and reduced inpatient and procedural volume. Greater likelihood for CIED implant was associated older age, Hispanic race, HTN, hyperlipidemia, coronary artery disease, and increased procedure volume.
Conclusions: Analyzing a large US database over 11 years demonstrates falling hospitalizations and CIED implantation for SSS. There are a number of relevant variables that impact if a CIED is utilized that include not only clinical features but also nonclinical variables such as socioeconomic status, gender, type and location of hospital and hospital procedure volume.
Author Disclosures: A. Guha: None. X. Xiang: None. D. Patel: None. V.V. Fedorov: None. E.G. Daoud: None.
- © 2016 by American Heart Association, Inc.