A nationwide cohort analysis to determine the prevalence of sinus node dysfunction and rates of pacemaker implantation in systemic lupus erythematosus

Karthik Gonuguntla; Komal Ejaz; Chaitanya Rojulpote; Ayesha Shaik; Abhijit Bhattaru; Tapan Buch; Sreekant Avula; Rahul Rauniyar; Vijay Singh; Pranav Karambelkar; Pranathi Narayanareddy; Kashyap Kela; Richard G Cowden; Nikola Perosevic; Pranjal Boruah

A nationwide cohort analysis to determine the prevalence of sinus node dysfunction and rates of pacemaker implantation in systemic lupus erythematosus

Am J Cardiovasc Dis. 2021 Aug 15;11(4):478-483. eCollection 2021.

Authors

Affiliations

¹ Department of Medicine, University of Connecticut Farmington, CT, USA.
² Department of Medicine, The Wright Center for Graduate Medical Education Scranton, PA, USA.
³ Department of Nuclear Cardiology, University of Pennsylvania PA, USA.
⁴ Department of Cardiology, The Wright Center for Graduate Medical Education Scranton, PA, USA.
⁵ Department of Medicine, Pennsylvania Hospital of The University of Pennsylvania Philadelphia, PA, USA.
⁶ Department of Psychology, University of Free State Bloemfontein, South Africa.
⁷ Department of Cardiology, Geisinger Community Medical Center Scranton, PA, USA.

PMID: 34548946
PMCID: PMC8449194

Abstract

Systemic lupus erythematosus (SLE) has been known to have various degrees of cardiac involvement. However, limited evidence exists on prevalence of heart rhythm disorders in patients with SLE who have subsequent pacemaker (PM) implantation. The purpose of this study was to examine the prevalence of sinus node dysfunction (SND) in patients with SLE. The data was retrospectively analysed from the National Inpatient Sample database for the years 2010 to 2014 using the International Classification of Disease-9 diagnosis codes for SLE and SND in patients 18 years or older. We analysed data of 158,368 patients with SLE that were admitted from 2010 to 2014. The sample of patients ranged between 18 and 101 years of age (M = 52.13 ± 17.61), were primarily female (88.2%), and were Caucasian (50.6%). The prevalence of SND was 4.3%. In patients with both SLE and SND, the prevalence of PM implantation over the five-year period of analysis was 3.6% and the majority of these patients had a dual-chamber PM (85.6%). Prevalence rates of SND in patients with SLE increased for females over this five-year period (p = 0.023). Prevalence estimates of complications associated with PM in patients with SLE and SND were venous thromboembolism (2.1%), cardiac tamponade (0.4%), sepsis and severe sepsis (0.4%), septic shock (0%), pneumothorax (0%) and PM site hematoma (1.7%). The findings of this study revealed that the prevalence of SND and the prevalence of PM in patients with both SLE and SND have remained relatively consistent over the five years that our study analysed.

Keywords: NIS; SLE; pacemaker; sinus node dysfunction.