Abstract 20796: Effect of in Situ Automatic Implantable Cardioverter-Defibrilator(AICD) on the in Hospital Outcomes in the Patients With Takotsubo Cardiomyopathy
Introduction: Hospitalizations of takotsubo cardiomyopathy (TTC) have been rising in last decade. There is limited data reporting mortality associated with the disease. It can occasionally present as sudden cardiac death secondary to fatal arrhythmias, especially in the patients with long QT interval. TTC itself can prolong QT interval and in such patients automated implantable cardioverter defibrillator (AICD) is used to prevent fatal arrhythmias.
Hypothesis: We assessed the effect of previously inserted AICD in patients with TTC on outcomes of in- hospital mortality, length of stay, cardiac arrest and hospitalization costs.
Methods: We used the Nationwide Inpatient Sample (NIS) database to estimate annual hospitalizations from 2006-2012 with principal discharge diagnosis TTC. We used ICD-9 code 429.83 to identify TTC related hospitalizations and implantation of AICD at the time of hospitalization was identified by ICD-9-CM diagnosis code V45.02. Multivariate logistic regression analyses were performed to assess the impact of in-situ AICD on in-hospital outcomes of TTC.
Results: An estimated 19,693 (weighted n=94,392) patients were identified with principal discharge diagnosis TTC. Among these, 104 (weighted n=507) patients had AICD and 19,589 (weighted n=93,885) were without AICD. As shown in table 1 it showed that AICD group patients had decreased Length of stay (-1.9 days, 95% CI -3.4 to -0.4), decreased Cost of Stay ($ -7911, 95 %CI -13,155 to -2,666) and lesser incidence of Cardiac Arrest (OR <0.001, 95 %CI <0.001 to <0.001) than Non-AICD group. There was no difference noted for mortality.
Conclusion: In patients with TTC, a pre-implanted AICD decreases outcomes of cardiac arrest, length of Stay, and hospitalizations cost. Further prospective studies needs to be done to identify importance of AICD implantation in patients with TTC, which may result in major cost savings in the healthcare system.
Author Disclosures: R.G. Soni: None. M. Pahuja: None. B. Thakkar: None. S. Singh: None. D.G. Patel: None.
- © 2016 by American Heart Association, Inc.