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Background The impact of atrial fibrillation (AF) among patients with amyloidosis on in‐hospital outcomes is not well‐established. We aimed to examine in‐hospital outcomes among patients admitted with a primary diagnosis of AF with and without amyloidosis. Methods and Results We queried the Nationwide Readmissions Database to compare the in‐hospital outcomes among AF patients with and without amyloidosis. Our study demonstrated that in‐hospital all‐cause mortality, adverse events, and 30‐day readmission were comparable between the two groups. Conclusions Patients with AF and concurrent amyloidosis did not have worse in‐hospital outcomes than those with AF alone. While there was an increasing trend of admission for atrial fibrillation with amyloidosis, patients with atrial fibrillation and concurrent amyloidosis did not have worse in‐hospital outcomes and adverse events than those with atrial fibrillation alone.

Background The real‐world data on the safety profile of ventricular tachycardia (VT) ablation among elderly patients is not well‐established. This study aimed to evaluate the procedural outcomes among those aged 18–64 years versus those aged ≥65 years who underwent catheter ablation of VT. Method Using the Nationwide Readmissions Database, our study included patients aged ≥18 years who underwent VT catheter ablation between 2017 and 2020. We divided the patients into non‐elderly (18–64 years old) and elderly age groups (≥65 years old). We then analyzed the in‐hospital procedural outcome and 30‐day readmission between these two groups. Results Our study included 2075 (49.1%) non‐elderly patients and 2153 (50.9%) elderly patients who underwent VT ablation. Post‐procedurally, elderly patients had significantly higher rates of prolonged index hospitalization (≥7 days; 35.5% vs. 29.3%, p < .01), non‐home discharge (13.4% vs. 6.0%, p < .01), 30‐day readmission (17.0% vs. 11.4%, p < .01), and early mortality (5.5% vs. 2.4%, p < .01). There was no significant difference in the procedural complications between two groups, namely vascular complications, hemopericardium/cardiac tamponade, cerebrovascular accident (CVA), major bleeding requiring blood transfusion, and systemic embolization. Through multivariable analysis, the elderly group was associated with higher odds of early mortality (OR: 7.50; CI 1.86–30.31, p = .01), non‐home discharge (OR: 2.41; CI: 1.93–3.00, p < .01) and 30‐day readmission (OR: 1.58; CI 1.32–1.89, p < .01). Conclusion Elderly patients have worse in‐hospital outcome, early mortality, non‐home discharge, and 30‐day readmission following catheter ablation for VT. There was no significant difference between elderly and non‐elderly groups in the procedural complications. Our study suggests that elderly patients have poorer in‐hospital outcome, early mortality, non‐home discharge, and 30‐day readmissions following catheter ablation for VT. However, elderly patients do not have a higher risk of procedural complications.

Background The transdermal patch of bisoprolol available in Japan has been reported to demonstrate superior efficacy in preventing postoperative atrial fibrillation, possibly surpassing its oral counterpart. However, there has been no systematic review and meta‐analysis assessing the efficacy of transdermal bisoprolol. Methods A comprehensive systematic literature search was conducted on PubMed, Embase, and Cochrane to identify all relevant studies assessing the efficacy of transdermal bisoprolol in preventing postoperative atrial fibrillation. The search covered studies from inception up to December 4, 2023. For data analysis, Review Manager (RevMan) 5.4 software was employed, using a random‐effects model to calculate risk ratios (RR) and 95% confidence intervals (CI). Results Three studies, comprising a total of 551 patients (transdermal bisoprolol 228 and control 323), were included. There was a decreased risk of postoperative atrial fibrillation or atrial tachyarrhythmias in patients treated with transdermal bisoprolol (RR 0.43, 95% CI 0.27–0.67, p = .0002, I2 = 0%). Conclusion Transdermal administration of bisoprolol has consistently shown efficacy, and this pooled analysis supports its effectiveness. The heterogeneity of the included studies limits certain interpretations. Future randomized clinical trials may elucidate the superiority of transdermal administration over oral administration. Transdermal bisoprolol effectively reduces postoperative atrial fibrillation, potentially outperforming oral formulations.

Background Evidence on the impact of obesity on catheter ablation for ventricular tachycardia (VT) is scarce. Method and Results We queried the Nationwide Readmissions Database to determine the hospital outcomes and procedural complications of VT ablation among the obese and nonobese populations. Obesity was associated with a more prolonged length of stay (p < .01), higher cost of hospitalization (p < .01), and higher rates of pericardial effusion or hemopericardium (p = .05) and vascular complications (p = .05). There was no significant difference in early mortality, 30‐day readmissions, and other procedural complications. Conclusion VT ablation could be performed relatively safely among patients with obesity. Our manuscript analyses the in‐hospital procedural outcomes of catheter ablation for VT between obese and non‐obese patients and found that VT ablation in obese patients has no significant difference in 30‐day mortality or 30‐day readmissions, but they do have increased vascular and pericardial effusion or hemopericardium complication rates, prolonged hospital stay (>7 days), and cost of hospitalization.

Hospitalization has been associated with the development of sarcopenia. This study aimed to examine the new incidences of hospital sarcopenia, associated risk factors and health outcomes, as defined by internationally recognized diagnostic criteria in hospitalized older people. Pre-defined search terms were run through five databases. Six studies that assessed sarcopenia on two separate time points during hospitalization on older inpatients were included. Prevalence of sarcopenia varied from 14.1% to 55% depending on diagnostic criteria and cut-off points used. New sarcopenia occurred between 12% to 38.7% patients following hospitalization. Risk factors were older age, longer duration of bed rest, lower baseline body mass index, cognitive impairment and activities of daily living disability. None of the studies reported health outcomes associated with newly developed sarcopenia in hospital.

BackgroundTransvenous lead removal (TLR) is associated with increased mortality and morbidity. This study sought to evaluate the impact of TLR on in-hospital mortality and outcomes in patients with and without CIED infection.MethodsFrom January 1, 2017, to December 31, 2020, we utilized the nationally representative, all-payer, Nationwide Readmissions Database to assess patients who underwent TLR. We categorized TLR as indicated for infection, if the patient had a diagnosis of bacteremia, sepsis, or endocarditis during the initial admission. Conversely, if none of these conditions were present, TLR was considered sterile. The impact of infective vs sterile indications of TLR on mortality and major adverse events was studied.ResultsOut of the total 25,144 patients who underwent TLR, 14,030 (55.8%) received TLR based on sterile indications, while 11,114 (44.2%) received TLR due to device infection, with 40.5% having systemic infection and 59.5% having isolated pocket infection. TLR due to infective indications was associated with a significant in-hospital mortality (5.59% vs 1.13%; OR = 5.16; 95% CI 4.33–6.16; p < 0.001). Moreover, when compared with sterile indications, TLR performed due to device infection was associated with a considerable risk of thromboembolic events including pulmonary embolism and stroke (OR = 3.80; 95% CI 3.23–4.47, p < 0.001). However, there was no significant difference in the conversion to open heart surgery (1.72% vs. 1.47%, p < 0.111), and infection was not an independent predictor of cardiac (OR = 1.12; 95% CI 0.97–1.29) or vascular complications (OR = 1.12; 95% CI 0.73–1.72) between the two groups.ConclusionHigher in-hospital mortality and rates of thromboembolic events associated with TLR resulting from infective indications may warrant further pursuing this diagnosis in patients.

Introduction Despite the growing use of CAR‐T therapy, adults over 65 still receive this treatment less frequently than younger patients. Methods Using the Nationwide Readmissions Database (2018–2020), we analyzed 2928 CAR‐T recipients, dividing them into young (18–40), middle‐aged (41–65), and older adults (≥ 66). Propensity score matching (caliper of 0.2, 1:1:1 ratio) was performed. We adjusted for the following confounding variables: gender, comorbidities, and social factors including smoking, alcohol use, and illicit drug use. Results Older adults had the highest rates of acute kidney injury (11.7% vs. 13.0% vs. 18.1%, p = 0.02) and cardiac complications (2.0% vs. 3.6% vs. 5.4%, p = 0.03). These three different age groups had comparable rates of leukopenia (45.0% vs. 42.7% vs. 39.1%, p = 0.10), infection (41.0% vs. 43.6% vs. 42.1%, p = 0.74), neurotoxicity (6.2% vs. 6.5% vs. 7.7%, p = 0.52), and pulmonary embolism (1.0% vs. 2.9% vs. 2.3%; p = 0.2). Despite the highest rates of non‐home discharge among the older patients (14.0% vs. 7.5% vs. 8.8%), there were no significant differences in early mortality (5.2% vs. 6.2% vs. 6.7%, p = 0.34), 30‐day readmission (23.1% vs. 23.8% vs. 24.4%, p = 0.48), prolonged index hospitalization (96.1% vs. 94.8% vs. 93.6%, p = 0.14), and total length of stay (21.2 days vs. 18.2 days vs. 21.3 days, p = 0.58). Conclusion CAR‐T therapy is safe among older adults with close monitoring for cardiac and renal complications.

Background Chimeric Antigen Receptor (CAR) T‐cell therapy has arisen as a revolutionary treatment for hematologic malignancies. Our study aimed to evaluate how sex differences affect outcomes and complications following CAR T‐cell therapy. Methods Utilizing the Nationwide Readmissions Database (2018–2020), we identified patients and divided them into male and female groups. Hospital outcomes and complications were compared among these two groups after propensity score matching to match groups based on comorbidities, producing two comparable cohorts. Results We analyzed 2928 patients (1832 males, 62.6%, mean age 60.3 ± 13.7 years; 1096 females, 37.4%, mean age 59.1 ± 13.8 years). After propensity score matching (1:1ratio), 1092 males and females were compared. There were no significant sex differences in early mortality (adjusted odd ratios (aOR): 1.04 [95% CI 0.69–1.57]), 30‐day readmissions (aOR: 1.05 [95% CI 0.86–1.30]), or nonhome discharge (aOR: 0.89 [95% CI 0.60–1.31]). Females had higher odds of leukopenia (aOR: 1.26 [95% CI 1.06–1.50]) but lower odds of acute kidney injury (aOR: 0.68 [95% CI 0.52–0.88]). Conclusions No sex differences were found in hospital outcomes, including early mortality, 30‐day readmission, and nonhome discharge after CAR T‐cell therapy.