Abstract 13633: Cardiac Arrhythmias in Hospitalized Patients With Hereditary Hemochromatosis

Abstract

Introduction: Cardiac iron overload in Hereditary Hemochromatosis (HH) can lead to conduction disturbances, arrhythmias, and rarely, cardiac arrest. There is a paucity of data on HH and the burden of cardiac arrhythmias and its repercussions. Hypothesis: To determine baseline characteristics of HH patients with and without arrhythmias, frequency of subtypes of arrhythmias, and related in-hospital outcomes such as mortality, length of stay (LOS), and total hospital costs. Methods: An HH-related adult hospitalizations with or without arrhythmias were analyzed using the National Inpatient Sample database from 2016 to 2018. We used propensity score matching to balance out the differences in baseline characteristics among the 2 groups. Results: Out of 10455 HH hospitalizations, 2525 (24.2 %) had concurrent arrhythmias. The arrhythmia cohort consisted of older patients (mean age, 68.9 vs 59.8 years), predominantly males (71.1% vs 61.5%), and Caucasians (92.5% vs 89.3%) compared to those without arrhythmia (p<.001). HH patients with arrhythmias had an almost 3-fold higher prevalence of congestive heart failure (11.5% vs 3.7%) and coronary artery disease (33.3% vs 12.2%) (p<.001). Atrial fibrillation (AF) (73.3%) was the most common arrhythmia followed by atrial flutter (8.3%), ventricular tachycardia (8.1%), and supraventricular tachycardia (7.7%). The arrhythmia cohort had higher mortality (6.7% vs. 2.3%) and mean hospital cost ($ 25,957 vs $16,742) as compared to the non-arrhythmia cohort ( P < .001). Mean LOS (6.7 vs 5.7 days, p=0.007) was comparable between the groups. Conclusions: Our study suggests a high burden of arrhythmia in HH-hospitalizations with AF being the most common arrhythmia. The arrhythmia cohort had significantly higher in-hospital mortality, and hospitalization cost. This warrants further studies to better delineate pathogenesis and early diagnosis and treatment strategies specifically curated for HH-associated arrhythmias.