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Competing Interests: Declaration of Competing Interest The authors have no competing interests to declare.

Evidence regarding racial disparities in leadless pacemaker (LP) utilization and outcomes is limited. We aimed to explore ethnicity-based disparities in LP utilization and clinical outcomes of patients who underwent LP implantation. All consecutive patients who underwent LP between January 2019 and January 2023 at our institution were included. Charts were reviewed for baseline characteristics and clinical outcomes. The primary outcomes were procedure-related complications, cardiac rehospitalization, worsening heart failure (HF) or HF hospitalization, and all-cause mortality. All statistical analyses were performed using SPSS Statistics 22 (IBM Corp., Armonk, NY). The p <0.05 was considered statistically significant. A total of 196 adult patients underwent LP implantation during the study period (48% Caucasians, 36.2% Hispanic, 8.2% Asians, and 7.7% African-American). The groups were balanced with respect to baseline demographics, clinical characteristics, and procedure-related complications. During the median follow-up of 104 days (interquartile range 24 to 382), no statistically significant differences were observed in worsening HF or HF hospitalization or all-cause mortality among the ethnic groups. After multivariable logistic regression, Asian individuals had higher odds of cardiac readmissions (odds ratio 4.1, 95% confidence interval 1.4 to 12.3, p = 0.01). Patients from racial and ethnic minorities face significant inequities in arrhythmia care, including patients who have undergone LP implantation. Awareness and a system-based approach (understanding cultural preferences, effective application of evidence-based guidelines, and population-based policies) are crucial to lessen disparities in health care among minorities., Competing Interests: Declaration of Competing Interest The authors have no competing interests to declare., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Little is known about the association between acute prevalent conditions in patients with type 2 Myocardial Infarction (T2MI) and clinical outcomes, particularly between genders. Using the Nationwide Inpatient Sample (2017), we examined outcomes of T2MI in patients stratified by prevalent associated conditions (renal failure, decompensated heart failure, infection, acute respiratory failure, cardiac arrhythmias, bleeding) and gender. Multivariable logistic regression was performed to assess the odds ratios (OR) of in-hospital all-cause mortality in each of the study groups. A total of 38,715 T2MI patients were included in the analysis, of which 47.9% (n = 18,540) were females. Renal failure was the most common prevalent condition in both genders (males: 60%; females: 52.6%). Acute respiratory failure was associated with the greatest odds of mortality (OR 5.46, 95% confidence interval (CI) 5.02 to 5.94) when compared with other conditions: renal failure (OR 2.20 95% CI 2.01 to 2.40), infections (OR 2.96 95% CI 2.72 to 3.21), major bleeding (OR 1.71 95% CI 1.52 to 1.93), arrhythmias (OR 1.30 95% CI 1.19 to 1.43) and decompensated heart failure (OR 0.71, 95% CI 0.65 to 0.77). However, there was no difference in mortality between genders for all acute conditions except renal failure (females OR: 1.02, 95% CI 1.02 to 1.02, p = 0.011). In conclusion, in-hospital mortality after T2MI differs according to the underlying acute condition, with acute respiratory failure being associated with the highest rate of mortality. No significant differences in mortality were observed between genders amongst all prevalent acute conditions, with the exception of renal failure which was marginally higher in females., Competing Interests: Declaration of Interests The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2021 Elsevier Inc. All rights reserved.)