Abstract 9694: Incidence and Outcomes of Hospitalized Patients With Torsades de Pointes

Abstract

Introduction: TdP is a polymorphic VT that occurs with prolonged QT interval and can cause sudden cardiac death. Trends in incidence and outcomes of TdP during the COVID-19 pandemic are not well-established. We aim to report incidence of intrahospital TdP and VT, baseline characteristics of patients with TdP, and trends in post-TdP recovery and mortality before and during the COVID-19 pandemic. Methods: Patients with diagnoses of VT and TdP from 2016-2020 at our institution were included. The diagnosis was confirmed after analysis of the patients’ ECGs. Demographics, medical history, and hospital course data were collected. Chi-square/Fisher’s exact, one-way ANOVA, and logistic regression analyses were conducted. Results: Seventy-four patients were included in the analysis. Average age was 60 ± 17, and 57% were male. Fifty-two (70%) patients were in the ICU at time of TdP. Co-morbidities included hypertension (53%), atrial fibrillation/flutter (41%), diabetes mellitus (34%), CAD (26%), and CKD (22%). Average LVEF was 39 ± 19%. Forty-two (57%) underwent emergent defibrillation, 19 (26%) required transvenous pacing, and 7 (10%) were administered isoproterenol for acute management of TdP. Median recovery time of QTc interval to <500ms was 3 days. Twenty-two (30%) received an ICD. Follow-up device check data was available for 15 patients; 4 had at least 1 episode of NSVT. Fifteen (20%) patients died during their admissions. The proportion of patients with VT that had TdP increased in 2020 compared to prior years (p<0.001). However, the proportion of patients with TdP that died during admission was not significantly different across 2016-2020. Conclusions: The proportion of patients with TdP relative to those with VT increased significantly in 2020, concurrent with the first wave of the COVID-19 pandemic. The absolute number of hospitalized patients with TdP did not change from 2016-2020. Mortality rate in patients with TdP did not differ significantly from 2016-2020.