Burden of arrhythmias in peripartum cardiomyopathy: Analysis of 9841 hospitalizations

作者：Mallikethi Reddy Sagar^*; Akintoye Emmanuel; Trehan Naveen; Sharma Shikha; Briasoulis Alexandros; Jagadeesh Kavyashri; Rubenfire Melvyn; Grines Cindy L; Afonso Luis

来源：International Journal of Cardiology, 2017, 235: 114-117.

DOI：10.1016/j.ijcard.2017.02.084

• Arrhythmias
• Peripartum cardiomyopathy

Background: Peripartum cardiomyopathy (PPCM) is associated with significant morbidity and mortality. Arrhythmogenic causes of death have been implicated in a significant number of patients. However, there is a dearth of systematic studies evaluating the burden of arrhythmias in PPCM.
Methods: We used the Healthcare Utilization Project, Nationwide Inpatient Sample database (2007-2012) and identified 9841 hospitalizations for women aged >= 18 years with a primary diagnosis of PPCM. Frequency of arrhythmias, utilization of electrophysiologic procedures, length of stay, hospitalization costs and outcomes associated with arrhythmias were determined.
Results: Mean age was 30.05 +/- 6.69 years. Arrhythmias were present in 18.7% of hospitalized PPCM cohort. Ventricular tachycardia was the most common arrhythmia and was noted in 4.2%. Approximately 2.2% of cases experienced cardiac arrest. Electrical cardioversion was performed in 0.3%, Catheter ablation in 1.9%, PPM implantation in 3.4% and ICD in 6.8% of hospitalizations for PPCM with arrhythmias. In-hospital mortality was 3-times more frequent in arrhythmia cohort (2.1% vs. 0.7%). Hospitalization costs were significantly higher in PPCM with arrhythmias. Elixhauser comorbidity score (adjusted OR: 1.10; 95% CI: 1.02-1.18; p = 0.016), in hospital mortality (adjusted OR: 2.35; 95% CI: 1.38-4.02; p = 0.002), cardiogenic shock (adjusted OR: 2.61; 95% CI: 1.44-4.72; p = 0.002), utilization of balloon pump (adjusted OR: 13.4; 95% CI: 2.55-70.53; p < 0.001), Swan-Ganz catheterization (adjusted OR: 3.12; 95% CI: 1.21-8.06; p= 0.019), and coronary angiography (adjusted OR: 1.79; 95% CI: 1.19-2.70; p = 0.005) were significantly associated with arrhythmias in PPCM.
Conclusions: Arrhythmias were present in 18.7% of PPCM related hospitalizations. Morbidity, in-hospital mortality, length of inpatient stay, hospitalization costs and cardiac procedure utilization were significantly higher in the arrhythmia cohort.

• 出版日期2017-5-15