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

<h2>Abstract</h2><h3>Background</h3> Patients admitted for ventricular arrhythmia (VA) are at risk for severe deterioration and mortality. <h3>Objective</h3> The aim of this study was to identify factors associated with in-hospital mortality in patients treated for VA. <h3>Methods</h3> 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. <h3>Results</h3> In total, 2,514 patients with VA were analyzed: mean age 65±13 years, 22% female, 59% ischemic cardiomyopathy, 23% non-ischemic cardiomyopathy, 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 (OR 0.39, 95% 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, while 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. <h3>Conclusion</h3> 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.