The risk of arrhythmias and sudden cardiac death significantly affected medium and long-term outcomes in heart transplant (HT) recipients, who were a special and susceptible population. Data from the National Inpatient Sample from 2009 to 2018 were examined retrospectively. Patients who underwent HT or who have had HT and received newly implanted cardioverter-defibrillators (ICDs) were included in the hospitalization data (excluding the preexisting ICD). Inpatient mortality, duration of stay, and inflation-adjusted expenditures were among the outcomes evaluated. Researchers looked at the mean length of stay, temporal trends in ICD placement, and ICD placement factors. Between 2009 and 2018, there were 22,673 hospitalizations for HT, during which patients either had a new ICD placed concurrently (n=70; 0.31%) or not at all (n=22,603; [99.7%]). There were 146,555 admissions of patients having a history of HT throughout the same time frame. Costs for installing an ICD in patients who already had HT were considerably greater when corrected for inflation ($55,680.7 vs. $17,219.2; P<0.001). Patients with HT who had previously undergone PCI were more likely to experience cardiac arrest while hospitalized (odds ratio [OR]:14.3 [3.5 to 58.6], drug addiction (OR:6.0 [1.3 to 27.1], and prior PCI) (OR:6.0 [2.1 to 17.3]). Putting an ICD in patients with a history of HT resulted in significantly higher inflation-adjusted expenses. Cardiac arrest during hospitalization, prior PCI, and drug addiction were all associated with a higher likelihood of receiving an ICD in patients with HT history.

Source – ajconline.org/article/S0002-9149(22)00403-9/fulltext