Exploring the Relationship between Group 2 Pulmonary Hypertension and Complete Heart Block: A United States Population Based Study

Background Existing literature highlights unfavorable outcomes for patients with cardiac conduction disorders and Pulmonary Hypertension (PH). However, limited data exist on complete heart block (CHB) outcomes in the context of group 2 PH. Aims To utilize a large national inpatient dataset to evaluate the association between group 2 PH and hospitalization outcomes in patients with CHB. Methods The 2016−2019 Nationwide readmissions database was queried to identify cases of CHB. In‐hospital outcomes were compared based on the presence vs absence of group 2 PH. The primary outcome was mortality. Secondary outcomes included odds of acute kidney injury (AKI), permanent pacemaker (PPM) and temporary pacemaker (TPM) use, cardiac arrest, all cause 30‐day readmissions, stroke, length of stay (LOS) and total charges (THC). Multivariable regression models adjusted for confounders. Results Among 169,724 CHB cases, 316 (0.2%) had a secondary diagnosis of group 2 PH. Group 2 PH was associated with a higher mortality during index hospitalization compared to the patients without PH (adjusted OR [aOR] 1.72, 95% CI 1.05–2.81, p = 0.030). Additionally, group 2 PH was associated with lower odds of PPM (aOR 1.53, 95% CI 1.26–1.85, p < 0.001), longer LOS (5 vs. 3.69 days, p < 0.001) and higher THC ($120,070 vs. $99,369, p < 0.001). No differences were observed regarding odds of TPM use, cardiac arrest, stroke, AKI or all cause 30‐day readmissions between both groups. Conclusions Among patients with CHB, the presence of group 2 PH was associated with higher rates of fatal and non‐fatal adverse outcomes and lower utilization of PPMs compared to those without group 2 PH.