Burden of Arrhythmias in Epilepsy Patients: A Nationwide Inpatient Analysis of 1.4 Million Hospitalizations in the United States

Abstract

Arrhythmias have been one of the common complications in epilepsy patients and have also been the reason for death. However, limited data exist about the burden and outcomes of arrhythmias by subtypes in epilepsy. Our study aims at evaluating the burden and differences in outcomes of various subtypes of arrhythmias in epilepsy patient population. The Nationwide Inpatient Sample (NIS) database from 2014 was examined for epilepsy and arrhythmias related discharges using appropriate International Classification of Disease, Ninth Revision Clinical Modification (ICD-9-CM) codes. The frequency of arrhythmias, gender differences in arrhythmia by subtypes, in-hospital outcomes and mortality predictors was analyzed. A total of 1,424,320 weighted epilepsy patients was determined and included in this study. Around 23.9% (n =277,230) patients had cardiac arrhythmias. The most frequent arrhythmias in the descending frequency were: atrial fibrillation (AFib) 9.7%, other unspecified causes 7.3%, sudden cardiac arrest (SCA) 1.4%, bundle branch block (BBB) 1.2%, ventricular tachycardia (VT) 1%. Males were more predisposed to cardiac arrhythmias compared to females (OR [odds ratio]: 1.1, p <0.001). The prevalence of most subtypes arrhythmias was higher in males. Arrhythmias were present in nearly a quarter of patients with epilepsy. Life threatening arrhythmias were more common in male patients. The length of stay (LOS) and mortality were significantly higher in epilepsy patients with arrhythmia. It is imperative to develop early diagnosis and prompt therapeutic measures to reduce this burden and poor outcomes due to concomitant arrhythmias in epilepsy patients.

Primary Causes of Hospitalizations and Procedures, Predictors of In-hospital Mortality, and Trends in Cardiovascular and Cerebrovascular Events Among Recreational Marijuana Users: A Five-year Nationwide Inpatient Assessment in the United States

“…Heart rate variability, a marker for autonomic dysfunction, can ultimately lead to sudden death from arrhythmia. In our study, we learned that trends in hospital presentation for epilepsy and arrhythmia among the marijuana users increased in recent years consistent with recently published study depicting increasing trends in arrhythmia including all subtypes of arrhythmia in marijuana users [ 25 ]. The burden of arrhythmias in epilepsy patients has been well depicted in the previous reports, which can present as parallel occurrences in marijuana users [ 26 ].…”

Rising Trends in Medication Non-compliance and Associated Worsening Cardiovascular and Cerebrovascular Outcomes Among Hospitalized Adults Across the United States

“…A review summarizing the impact of nonadherence on health care cost in several chronic diseases such as diabetes, CVD, and chronic obstructive pulmonary disease concluded that increasing the medication adherence significantly reduces the overall health care cost [16]. Our prior analyses have revealed close etiopathological and prognostic link of cardiovascular disorders and outcomes with endocrine, respiratory, or psychiatric disorders which also suggests that medications targeted for one organ system can help prevent overall complications, improve quality of life, and improve long-term prognosis [13,[17][18][19][20][21].…”

Heart Conduction and Rhythm Disorders in Iktal Epilepsy Period: The Prevalence and Predictors

“…Одним из факторов риска возникновения наджелудочковых нарушений ритма сердца в нашей работе явился мужской пол пациентов, что соответ ствует данным мировой литературы [10].…”