Cardiac Implantable Electronic Devices in Adults with Tetralogy of Fallot

Alexander Egbe, Saraschandra Vallabhajosyula, Emmanuel Akintoye, Abhishek Deshmukh

Research output: Contribution to journalArticle

Abstract

Patient with repaired tetralogy of Fallot (TOF) sometimes require cardiac implantable electronic devices (CIED) for tachy/bradyarrhythmias. There are no population-based studies of CIED-related outcomes in the adult TOF population. We reviewed the Nationwide/National Inpatient Sample to determine trends in CIED-related admissions in adults with TOF repair. This is a retrospective review of the Nationwide/National Inpatient Sample database from January 1, 2000 to December 31, 2014. There were 18,353 admissions in adults with TOF diagnosis, and of these, CIED were implanted in 792 (4.3%) admissions (CIED-related admissions). Of these 792 CIED-related admissions, pacemakers were implanted in 242 (30.7%) yielding an incidence of 1.3% and implantable cardioverter-defibrillators were implanted in 550 (69.4%) yielding an incidence of 3.0%. In-hospital mortality occurred in 14 (1.8%) of the CIED-related admissions. The mean hospital length of stay was 7.7 ± 1.3days and inflation-adjusted hospitalization cost was $141,860 ± $127,516. In 5-year intervals (2000 to 2004, 2005 to 2009, and 2010 to 2014), there was a temporal increase in the incidence of CIED-related admissions (3.7% vs 4.4% vs 4.9%, p = 0.006). There was a similar trend in the age at the time of implantation (37.7 ± 14.2vs 38.2 ± 13.1vs 39.0 ± 14.5years, p < 0.001) and Charlson Comorbidity Index (1.1 ± 1.4vs 1.4 ± 1.8vs 1.3 ± 1.7, p < 0.001). In conclusion, the incidence of CIED-related admissions was 4.3% and increased over time. Further studies are required to determine if the observed temporal increase in incidence of CIED implantations (particularly implantable cardioverter-defibrillators) is associated with a concomitant increase in incidence of aborted sudden cardiac death.

Original languageEnglish (US)
JournalAmerican Journal of Cardiology
DOIs
StatePublished - Jan 1 2019

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Tetralogy of Fallot
Equipment and Supplies
Incidence
Implantable Defibrillators
Inpatients
Length of Stay
Sudden Cardiac Death
Economic Inflation
Bradycardia
Hospital Mortality
Population
Comorbidity
Hospitalization
Databases
Costs and Cost Analysis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Cardiac Implantable Electronic Devices in Adults with Tetralogy of Fallot. / Egbe, Alexander; Vallabhajosyula, Saraschandra; Akintoye, Emmanuel; Deshmukh, Abhishek.

In: American Journal of Cardiology, 01.01.2019.

Research output: Contribution to journalArticle

Egbe, Alexander ; Vallabhajosyula, Saraschandra ; Akintoye, Emmanuel ; Deshmukh, Abhishek. / Cardiac Implantable Electronic Devices in Adults with Tetralogy of Fallot. In: American Journal of Cardiology. 2019.
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abstract = "Patient with repaired tetralogy of Fallot (TOF) sometimes require cardiac implantable electronic devices (CIED) for tachy/bradyarrhythmias. There are no population-based studies of CIED-related outcomes in the adult TOF population. We reviewed the Nationwide/National Inpatient Sample to determine trends in CIED-related admissions in adults with TOF repair. This is a retrospective review of the Nationwide/National Inpatient Sample database from January 1, 2000 to December 31, 2014. There were 18,353 admissions in adults with TOF diagnosis, and of these, CIED were implanted in 792 (4.3{\%}) admissions (CIED-related admissions). Of these 792 CIED-related admissions, pacemakers were implanted in 242 (30.7{\%}) yielding an incidence of 1.3{\%} and implantable cardioverter-defibrillators were implanted in 550 (69.4{\%}) yielding an incidence of 3.0{\%}. In-hospital mortality occurred in 14 (1.8{\%}) of the CIED-related admissions. The mean hospital length of stay was 7.7 ± 1.3days and inflation-adjusted hospitalization cost was $141,860 ± $127,516. In 5-year intervals (2000 to 2004, 2005 to 2009, and 2010 to 2014), there was a temporal increase in the incidence of CIED-related admissions (3.7{\%} vs 4.4{\%} vs 4.9{\%}, p = 0.006). There was a similar trend in the age at the time of implantation (37.7 ± 14.2vs 38.2 ± 13.1vs 39.0 ± 14.5years, p < 0.001) and Charlson Comorbidity Index (1.1 ± 1.4vs 1.4 ± 1.8vs 1.3 ± 1.7, p < 0.001). In conclusion, the incidence of CIED-related admissions was 4.3{\%} and increased over time. Further studies are required to determine if the observed temporal increase in incidence of CIED implantations (particularly implantable cardioverter-defibrillators) is associated with a concomitant increase in incidence of aborted sudden cardiac death.",
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