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Published on: December 22, 2020
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Increased healthcare utilization associated with complete atrioventricular block in pacemaker patients
Suneet Mittal1,2, Dan L Musat3, Michael H Hoskins4
1The Snyder Center for Comprehensive Atrial Fibrillation, the Valley Health System, Ridgewood, NJ, USA. mittsu@valleyhealth.com.
Summary
Complete atrioventricular block (cAVB) significantly increases heart failure hospitalizations and healthcare costs in pacemaker patients. Early identification and alternative pacing strategies may reduce utilization.
Area of Science:
- Cardiology
- Electrophysiology
- Health Services Research
Background:
- Complete atrioventricular block (cAVB) necessitates pacemaker (PM) implantation.
- The impact of cAVB on subsequent heart failure hospitalization (HFH) and healthcare utilization in PM patients is not fully characterized.
Purpose of the Study:
- To characterize and quantify the impact of cAVB on HFH and healthcare utilization in pacemaker patients without prior heart failure.
Main Methods:
- Retrospective analysis of 21,202 dual-chamber PM patients from claims databases (2008-2014).
- Patients were stratified into cAVB (prior AV block or ablation) and noAVB groups.
- HFH and associated costs were compared post-implant.
Main Results:
- Patients with cAVB (n=6994) had a significantly increased risk of HFH (HR 1.59) compared to noAVB patients (n=14,208).
- cAVB was associated with significantly higher annual healthcare costs ($636 vs $369 per patient-year).
Conclusions:
- In dual-chamber PM patients without prior HF, cAVB significantly elevates HFH risk and healthcare utilization.
- Identifying high-risk patients and considering biventricular or conduction system pacing may mitigate HF-related costs.
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