Eleven‐year trends of inpatient pacemaker implantation in patients diagnosed with sick sinus syndrome

Abstract

Background Pacemakers (PM) are used for managing sick sinus syndrome (SSS). This study evaluates predictors and trends of PM implantation for SSS. Methods Patients were identified from the National Inpatient Sample dataset (2003–2013). Included patients were ≥18 years old, had a diagnosis of sinus node dysfunction and atrial arrhythmia (i.e., SSS). Patients who died, transferred out, who had prior device, or had a defibrillator or resynchronization therapy device implanted were excluded. Included patients were then stratified by if a PM was implanted. Data regarding SSS, trends of PM utilization, and multivariable models of factors associated with PM implantation are presented. Results Note that 328,670 patients satisfied study criteria. This study compared patients who underwent (87.4%) PM implantation to those who did not undergo (12.6%) PM implantation. The annual trends for hospitalization with SSS and PM placement have been decreasing (P <0.001). Variables associated with lower likelihood for PM implantation include young age, female sex, non-Caucasian race, chronic heart failure, Charlson Comorbidity Score ≥1, emergency room and week-end admission, hospital stay ≤3 days, and high cardiology inpatient volume. Greater likelihood for PM implantation was associated with hyperlipidemia, hypertension, and hospitals that were either private, large, Northeastern location, or with high cardiac procedural volume. Conclusions Analyzing 11-year data from a national inpatient database demonstrate a number of relevant variables that impact PM utilization that include not only clinical but also nonclinical variables such as socioeconomic status, gender, and hospital features. Racial and gender bias toward PM implantation are unchanged and persist through 2013.

Arrhythmia Perception and Quality of Life in Bradyarrhythmia Patients Following Permanent Pacemaker Implantation

“…Narasimhan et al (2017) found that patients who were older and had hypertensive and syncopal symptoms had a higher probability of having PPM implantation compared to others. In addition to clinical variables, nonclinical variables such as socioeconomic status or gender may also influence the efficacy of PPMs in patients (Guha et al, 2017). Moreover, the patients’ biopsychosocial adjustment after PPM implantation plays an important role in determining their QoL.…”

Cardiac implantable electrical devices in women

“…In patients age ≥ 80 years, women predominantly received single‐chamber ventricular devices, whereas men received more dual‐chamber devices. Guha et al analyzed 328 670 patients admitted for SSS (54.2% women) and found that women had lower rates of pacemaker implantation compared with men.…”

Patients with atrial fibrillation and permanent pacemaker: Temporal changes in patient characteristics and pharmacotherapy

“…A recent U.S study investigated patients with sick sinus node syndrome and PPMs from 2003 to 2013. They found that income above median quartile had an increased risk of receiving an PPM [ 19 ], and one of their main explanations for this was patient affordability of PPM. The Danish healthcare which is available free of charge to all inhabitants independent of socioeconomic status should rule out any patient concerns about affordability.…”