Spectrum of Arrhythmias Among Hospitalized Cardiac Patients in Bangladesh

Background: Cardiac arrhythmias are important complications of cardiovascular disease and may adversely affect clinical outcomes. However, evidence regarding their prevalence and associated clinical characteristics among hospitalized cardiac patients in Bangladesh remains limited. Objective: To determine the pattern of cardiac arrhythmias and assess their associations with cardiovascular conditions, echocardiographic findings, and in-hospital outcomes. Methods: This hospital-based cross-sectional observational study included 300 hospitalized cardiac patients at a tertiary-care cardiac centre in Bangladesh. Clinical assessments, 12-lead electrocardiography, and echocardiography were performed, with continuous cardiac monitoring when indicated. Arrhythmia patterns, comorbidities, left ventricular ejection fraction (LVEF), and in-hospital outcomes were evaluated. Results: Cardiac arrhythmias were documented in 126 patients (42.0%). Hypertension was the most frequently observed cardiovascular risk factor, affecting 190 patients (63.3%), followed by diabetes mellitus in 108 (36.0%) and dyslipidaemia in 94 (31.3%). Atrial fibrillation was the most common arrhythmia (19.3%), followed by premature ventricular contractions (13.7%), supraventricular tachycardia (6.0%), non-sustained ventricular tachycardia (5.7%), and sustained ventricular tachycardia (2.0%). Arrhythmias were more frequent among older patients and those with ischemic heart disease, heart failure, and valvular heart disease. Among patients with rheumatic heart disease, 50.0% had atrial fibrillation. Patients with arrhythmias had lower mean LVEF (45.8% vs. 52.4%; p<0.001) and more frequent left atrial enlargement (42.9% vs. 22.4%; p<0.001). Approximately 25.4% were asymptomatic at detection. In-hospital mortality was higher among patients with arrhythmias (7.1% vs. 2.3%; p=0.047). Conclusion: Cardiac arrhythmias were common among hospitalized cardiac patients, with atrial fibrillation predominating. Hypertension was the most prevalent cardiovascular risk factor, followed by diabetes mellitus and dyslipidaemia. Their associations with structural heart disease, impaired ventricular function, and increased in-hospital mortality underscore the importance of systematic ECG assessment and appropriate cardiac monitoring.