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Racial and Ethnic Disparities in Patients Who Underwent Leadless Pacemaker Implantation.

Jakrin Kewcharoen¹, Sohaib A Basharat¹, Ingrid Fobb-Mitchell¹

¹Division of Cardiology, Cardiac Arrhythmia Service, Loma Linda University Health, Loma Linda, California.

The American Journal of Cardiology

|October 15, 2023

Summary

Racial and ethnic minorities show disparities in leadless pacemaker (LP) care. While overall outcomes were similar, Asian patients had higher cardiac readmission rates, highlighting the need for equitable arrhythmia care.

Keywords:

arrhythmia leadless pacemaker racial disparity

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Published on: September 24, 2021

Area of Science:

Cardiology
Health Disparities
Medical Device Utilization

Background:

Limited evidence exists on racial disparities in leadless pacemaker (LP) use and outcomes.
Investigating ethnicity-based differences in LP implantation and clinical results is crucial.

Purpose of the Study:

To explore ethnicity-based disparities in leadless pacemaker (LP) utilization.
To analyze clinical outcomes, including complications and rehospitalizations, among diverse ethnic groups post-LP implantation.

Main Methods:

Retrospective review of 196 adult patients who underwent LP implantation between January 2019 and January 2023.
Analysis of baseline characteristics, procedure-related complications, cardiac rehospitalization, heart failure (HF) events, and all-cause mortality.
Multivariable logistic regression used to identify predictors of adverse outcomes.

Main Results:

No significant differences in procedure-related complications, HF worsening, or all-cause mortality were observed among ethnic groups.
Asian individuals demonstrated a statistically significant higher odds of cardiac readmissions (OR 4.1, p=0.01).
The study included 48% Caucasians, 36.2% Hispanic, 8.2% Asians, and 7.7% African-Americans.

Conclusions:

While overall LP outcomes appear equitable across ethnic groups, specific disparities like increased cardiac readmissions in Asian patients warrant attention.
System-based approaches and increased awareness are vital to reduce health inequities in arrhythmia care for minority populations.
Addressing cultural preferences and optimizing guideline application are key to achieving equitable healthcare for all patients receiving leadless pacemakers.