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Outcomes in heart failure patients with third-degree heart block during COVID-19

Benjamin Kash1, Ethan Wahle1, Eli Blaney1

  • 1Creighton University School of Medicine, Omaha, NE, United States.

Frontiers in Cardiovascular Medicine
|March 19, 2026
PubMed

Insights

Hospitalizations for heart failure with third-degree heart block showed no change in mortality or resource use during the COVID-19 pandemic. However, specific comorbidities were linked to increased in-hospital mortality for these patients.

Area of Science:

  • Cardiology
  • Public Health
  • Epidemiology

Background:

  • Heart failure is a frequent complication of third-degree heart block.
  • Understanding the impact of the COVID-19 pandemic on this patient population is crucial.

Purpose of the Study:

  • To examine trends in mortality and medical resource utilization for patients with heart failure and third-degree heart block before and during the COVID-19 pandemic.
  • To investigate outcomes across different demographics, hospital characteristics, and comorbidities.

Main Methods:

  • Analysis of adult hospitalizations with primary diagnosis of heart failure and history of third-degree heart block (2017-2022) from the National Inpatient Sample.
  • Primary outcome: all-cause mortality. Secondary outcomes: length of stay and total hospital charges.
  • Propensity matching, logistic regression for mortality, and linear regression for secondary outcomes were employed.

Main Results:

  • 22,900 prepandemic (2017-2019) and 37,530 pandemic (2020-2022) hospitalizations were identified.
  • No significant differences in all-cause mortality (p=0.36), length of stay (p=0.066), or total charges (p=0.65) were observed during the pandemic.
  • Increased odds of in-hospital mortality were associated with chronic pulmonary disease, valvular disease, uncomplicated diabetes, liver disease, and coagulopathy.

Conclusions:

  • The COVID-19 pandemic did not significantly alter mortality, length of stay, or hospital charges for patients hospitalized with heart failure and third-degree heart block.
  • Comorbidities such as chronic pulmonary disease, valvular disease, diabetes, liver disease, and coagulopathy are associated with increased mortality risk in this cohort.
Abstract

Keywords:
COVID-19 pandemicheart failurein-hospital mortalitylength of staythird-degree heart blocktotal hospital charges

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