Abstract 18855: Comparison of Hospital Outcomes in Sick Sinus Syndrome Patients With and Without Pacemaker- A Nationwide Inpatient Sample Analysis

Introduction: Sick sinus syndrome refers to degenerative fibrosis of the sinoatrial node, leading to bradyarrhythmias with or without tachyarrhythmias. Pacemaker implantation is a common therapeutic intervention in patients with symptomatic sick sinus syndrome (SSS). We aimed to analyze the periprocedural outcomes for patients with SSS who undergo pacemaker implantation.

Hypothesis: Pacemaker implantation is associated with lower odds of mortality in patients with sick sinus syndome.

Methods: Retrospective cohort study with data from 2016-18 combined National Inpatient Sample database. ICD-10 codes used to include admissions with SSS and dichotomized based on permanent dual chamber pacemaker implantation. The primary and secondary outcomes were studies between the two cohorts. Multivariate linear and logistic regression were used to adjust for confounders

Results: Out of 190,625 sick sinus syndrome, admissions in 2016-18 NIS database, 115,195 (60%) received a permanent pacemaker. Permanent pacemaker implantation in SSS patients was associated with lower adjusted odds of inpatient mortality (aOR 0.22, 95% CI 0.17-0.29, p<0.001), decrease in mean LOS by 0.31 days (5.55 vs 5.86, p<0.001) and higher adjusted THC by a difference of 35,489 USD (116,474 USD vs 80,985 USD, p< 0.001). Secondary outcomes are shown in Fig.

Conclusions: Pacemaker implantation in sick sinus syndrome patients is associated with 80% decrease in mortality, shorter length of stay, and significantly lower odds of inpatient complications including sepsis, pulmonary embolism, ventricular fibrillation, acute kidney injury when compared to patients without a pacemaker.