Abstract 10578: Outcomes of Tachy-Arrhythmias in Group 1 Pulmonary Arterial Hypertension versus Non-Group 1 Pulmonary Hypertension: A Comparison of Nationwide Analysis 10 Years Apart

Abstract

Introduction: Cardiac arrhythmias are associated with increased morbidity and mortality in patients with pulmonary hypertension (PH). We study the prevalence and outcomes of tachyarrhythmia in group 1, pulmonary arterial Hypertension (PAH) compared to non-group 1 PH, a decade apart (2007 vs 2017). Methods: National inpatient Sample database was used to identify PAH and non-group 1 PH using the ICD9-CM and ICD-10 codes for 2007 and 2017 respectively. Total hospitalizations, prevalence and mortality of cardiac tachyarrhythmia were analyzed. Results: Hospitalizations for PAH decreased from 2007 (17,713) vs 2017 (9,330). Hospitalizations for non-group 1 PH increased from 2007 (476,357) vs. 2017 (1,084,395). The most common tachyarrhythmia in PAH group was Atrial fibrillation/flutter (35.4% vs. 35.1% (p=0.648)), followed by Ventricular tachycardia (VT) (3.1% vs. 3.5% (p=0.143)), Supraventricular tachycardia (SVT) (paroxysmal atrial tachycardia, atrio-ventricular reentrant tachycardia and atrio-ventricular nodal reentrant tachycardia) (0.9 vs. 3.2% (p=<0.001)), then Ventricular fibrillation/flutter (0.3% vs. 0.3% (p=0.758)). Only SVT had significantly increased and none were associated with increased in-hospital mortality. Non-group 1 PH also had Atrial fibrillation/flutter (37.2% vs. 46.8% (p<0.001)) as the most common arrhythmia, followed by VT (3.6% vs. 4.5% (p<0.001)), then SVT 0.9% vs. 3.0% (p<0.001) and Ventricular fibrillation/flutter (0.3% vs. 0.6%(p<0.001)). There was significant increase in all tachyarrhythmia when comparing 2007 to 2017, and all arrhythmias were associated with increased in-hospital mortality. In-hospital cardiac arrest increased in both PAH group (1.0% vs. 1.6% (p<0.001)) and non-group 1 PH (0.7% to 1.4% (p<0.001)) and both were associated with increased in-hospital mortality (PAH group (OR 27.22, p<0.001) vs. non-group 1 PH(OR 1.66, <0.001)). Conclusions: This study shows that non-group 1 PH has higher prevalance of tachyarrhythmia, and is associated with higher mortality compared to Group 1 PAH. We need to come up with strategies for early prevention and treatment.