Nationwide trends and disparities in deaths from second- or third-degree atrioventricular block (1999-2022): A...

AV block prevalence increases with age: first-degree affects 6 % of adults over 60 with low mortality, second-degree is more serious, and third-degree, though rare (0.02 % in the U.S.), has a 37 % five-year survival rate if untreated. Analyzing mortality trends in second- or third-degree AV blocks in the U.S. is vital for treatment and identifying at-risk populations.

We analyzed death certificates from the CDC WONDER database (1999-2022) for second- and third-degree AV Block (ICD-10 codes I44.1 and I44.2) in individuals aged 25 and older. Age-adjusted mortality rates (AAMRs) and annual percent change (APC) were calculated by year, sex, age, race/ethnicity and geographics.

Between 1999 and 2022, 54,420 deaths were reported in patients with second- or third-degree AV block. The AAMR increased from 12.8 to 14.9, with a significant rise from 2013 to 2022 (APC: 7.26; 95 % CI: 6.13 to 9.96; p < 0.001). Older adults had higher AAMRs (45.0) compared to middle-aged (2.1) and young adults (0.3). Men had higher AAMRs than women (11.3 vs. 8.6). Ethnoracial disparities showed the highest AAMRs in NH American Indian individuals (13.3), followed by NH Black (10.5), NH White (9.8), Hispanic (7.3), and NH Asian individuals (5.9). Non-metropolitan areas had higher AAMRs than metropolitan areas (11.7 vs. 9.2).

Mortality from second- and third-degree AV block has increased since 1999, particularly in the last decade, with higher rates in men, older adults, NH American Indian or Alaska Native individuals, and non-metropolitan areas, highlighting the need for further research to address these disparities.