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.