Determination Causes of Readmission in Patients with Secondary Conduction Disorders in 2006-2017 in Shahid Madani Hospital, Tabriz

Abstract

There is little information about the prognosis and history of patients with drug-induced ventricular atrial block. Therefore, we aimed to examine patients in this study, referred between 2006 and 2017, with secondary conduction disorders symptoms. In order to determine the correct strategies for selecting patients who need pacemakers, reasons for implantation of pacemakers were studied for patients who were previously discharged. This would avoid potential issues for patients, improper pacemaker installation, and imposing excessive healthcare expenses. Methods: In order for the conduct of this study, a wide range of datasets were extracted and analyzed, as of which patients’ demographics such as age and sex were some of them. Additionally, information obtained in relation to the reason and rate of hospitalization, type of heart rhythm, QRS pattern, EF in echocardiography, type of drug used by patients, and time of pacemaker implantation. Results: In this study, out of 110 patients, 54 (49%) were readmitted. Results demonstrated a significant relationship between the type and dose of medication used by patients, and the causes and extent of initial hospitalization and patients’ readmission. Patients taking Betablocker and Digoxin together, and those who used Atenolol in doses above 100 mg daily, showed a more severe heart block. Patients taking Diltiazem over 90 mg daily, showed a higher number of sinus arrest incidents, and so [higher] readmission rate. Also, more readmission was observed for old patients with a lower level of consciousness than others. Likewise, more readmission was observed for patients who showed heartbeat rates of below 30 beats per minute and wide QRS on their first hospitalization ECG. In subgroup analysis (2:1 AVB with narrow QRS and CHB with Narrow QRS), less readmission was observed for young patients with a lower level of consciousness than others, but no relationship was found between drug-type and readmission rate in this [subgroup] analysis.