In-hospital mortality in a large seven-year single-center retrospective cohort of patients admitted for ventricular arrhythmia.

BACKGROUND

Patients admitted for ventricular arrhythmia (VA) are at risk for severe deterioration and mortality.

OBJECTIVE

This study aimed to identify factors associated with in-hospital mortality in patients treated for VA.

METHODS

Consecutive patients admitted for VA (premature ventricular contractions in the setting of structural heart disease, ventricular tachycardia, and/or ventricular fibrillation/flutter [VF]) between 2017 and 2024 were retrospectively analyzed. Patients with VA suffering from acute ST-segment elevation myocardial infarction were excluded. The primary outcome was in-hospital mortality. Logistic regression models were used to identify factors associated with the primary outcome in-hospital mortality.

RESULTS

In total, 2514 patients with VA were analyzed; mean age 65 ± 13 years, 22% female, 59% ischemic cardiomyopathy, 23% non-ischemic cardiomyopathy, and mean left ventricular ejection fraction 38 ± 13%. The overall in-hospital mortality rate was 20%. Catheter ablation (CA) for VA was performed in 20% of patients who were younger, and had lower rates of acute heart failure than patients who were treated conservatively. Antiarrhythmic drug therapy (odds ratio [OR], 0.39; 95% confidence interval [CI], 0.28-0.54), and CA for VA (OR, 0.12; 95% CI, 0.05-0.32) independently correlated with reduced in-hospital mortality, whereas the occurrence of VF (OR, 2.78; 95% CI, 2.03-3.78), and cardiogenic shock (OR, 4.08; 95% CI, 2.91-5.72) correlated with an increased risk for in-hospital mortality.

CONCLUSION

In-hospital mortality among patients hospitalized for VA was 20%. Factors correlated with reduced in-hospital mortality included CA and antiarrhythmic drug therapy. The occurrence of VF, and cardiogenic shock were correlated with increased in-hospital mortality.