O1008: Characteristics and Complications Among Neonates Undergoing Cardiac Implantable Electronic Device Procedures in the United States; An Insight from the 2016-2020 National Inpatient Sample

Background: Cardiac Implantable Electronic Devices (CIEDs) are used in neonates to manage underlying arrhythmias and heart blocks. There is a paucity of data about using these devices in the neonatal period.

Methods: In this study, we utilized the National Inpatient Sample (NIS) database from 2016 to 2020 to identify neonates undergoing CIED procedures. CIED procedures were identified using International Classification of Diseases, Tenth Revision, (ICD-10) codes. Multiple patient characteristics and post-procedural complications were also identified. Risk factors to mortality were analyzed via logistic regression models.

Results: A total of 470 neonates required a CIED between 2016 to 2020 (85 cases in 2016, 105 in 2017, 85 in 2018, 110 in 2019, and 85 in 2020). More than half of the patients (240, 51.1%) were females. The majority (42.6%) were White and the minority (17%) were Hispanic. All CIED procedures were conducted in urban teaching hospitals, with 51.1% being covered by Medicaid. 54.3% of the patients had an underlying congenital heart block. Several postprocedural complications such as pericardial effusion (13.8%), wound disruption (9.6%), pneumothorax (3.2%), and cardiogenic shock (10.6%) were recorded in our cohort. Mortality was 13.8% (65 patients). After adjusting for comorbidities and patient characteristics, the mortality was not associated with sex (p=0.144) or racial differences. However, neonates covered by private insurance had higher odds of death (19.4% vs. 8.3%, aOR 3.214, 95% CI 1.220-8.468, p=0.018, vs. Medicaid).

Conclusion: CIED procedures are more common in white female neonates with more than half of the patients having an underlying congenital heart block. Pericardial effusion was the most common post-operative complication with no difference in mortality between both genders.