A closer look at arrhythmia patterns and device implantation in cardiac sarcoidosis patients without heart failure: insights from national readmission database

SESSION TITLE: Inflammation and Immunity in Cardiovascular Disease SESSION TYPE: Original Investigations PRESENTED ON: 10/11/2023 08:30 am - 09:30 am PURPOSE: Cardiac sarcoidosis (CS) is linked to a heightened occurrence of arrhythmias. Limited information exists about arrhythmia, pacemaker, and defibrillator implantation in CS patients who do not have heart failure (HF). METHODS: Our objective is to depict the prevalence of arrhythmias, pacemakers, and defibrillator implantation in CS patients without HF, utilizing the National Readmission Database (NRD). A retrospective, descriptive study was performed using the NRD data from January 2016 to December 2019. Adult inpatient admissions (over 18 years) with CS without HF and 30-day readmissions were chosen based on the International Classification of Diseases-Tenth Revision criteria. RESULTS: 1,863 adult patients were admitted with CS without HF. Of these, the median age was 57 years interquartile range (IQR) (48-66), and 782 (42%) were women. Among the patients admitted with CS without HF, 29 (1.54%) died. 184 (10 %) were readmitted within 30 days. The median age of patients readmitted within 30 days was 56 years IQR (47-65) and 67 (35%) were women. During the index admission, the prevalence of atrial fibrillation/flutter (AF), atrioventricular block /left bundle block (AVLLB), sick sinus syndrome (SSS), ventricular tachycardia(VT), ventricular fibrillation (VF), and cardiac arrest (CA) was 480 (26%), 410 (22%), 46 (2.5%), 667 (36%), 65 (3.5%) and 37 (2%) respectively. Pacemaker and defibrillator implantation rates during the initial admission were 3.7% and 20%, respectively. Additionally, 34% and 7.5% had a history of defibrillator and pacemaker implantation. On 30-day readmission, the prevalence of AF was 40%; AVLLB was 9%; and VT was 34%. The most common principal diagnosis for 30-day readmission was ventricular tachycardia (21%), followed by pulmonary embolism, pulmonary sarcoidosis, sepsis, and persistent atrial fibrillation. CONCLUSIONS: In CS patients without HF, ventricular tachycardia is the most frequently observed arrhythmia and serves as the primary diagnosis for 30-day readmission. Furthermore, defibrillator implantation is more common than pacemaker implantation in this patient population. CLINICAL IMPLICATIONS: The clinical implications of these findings highlight the importance of early detection and management of ventricular tachycardia in CS patients without HF. Healthcare providers should carefully evaluate the benefits and risks of defibrillator and pacemaker implantation, using this information to guide treatment decisions. These insights can inform patient education and follow-up care, ultimately improving patient outcomes and reducing readmissions. DISCLOSURES: No relevant relationships by Yash Deshpande No relevant relationships by Chaitra Janga No relevant relationships by Kanishq Rajan Jethani No relevant relationships by Jesvin Jeyapaulraj No relevant relationships by Pranav Karambelkar No relevant relationships by Anand Reddy Maligireddy No relevant relationships by Koushik Sangaraju No relevant relationships by Sahithi Sharma