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Outcomes of patients admitted with ventricular arrhythmias and sudden cardiac death in the United States.

Abstract：

BACKGROUND:Mortality caused by ventricular arrhythmias (VAs) remains a problem of epidemic proportions. Understanding current trends on admission of VA, patient characteristics, morbidity, mortality, and health care utilization could help us improve allocation of health care resources and risk prediction. OBJECTIVE:The purpose of this study was to investigate clinical outcomes of VA, including ventricular tachycardia (VT), implantable cardioverter-defibrillator (ICD) shocks, and sudden cardiac death (SCD); and to identify predictors of morbidity and mortality, patterns of utilization of ICD and VT ablation, and the impact of such metrics on overall health care utilization. METHODS:From 2010-2015, we identified 290,998 VA hospitalizations, which were stratified into group 1: normal heart; group 2: ischemic heart disease (IHD); group 3: nonischemic heart disease (non-IHD); group 4: ICD shocks; and group 5: SCD (cardiac arrest without ICD shock). RESULTS:The number of admissions for VA decreased during the study period (except for patients with SCD and ICD shock, which increased); in-hospital mortality in patients admitted with VA and SCD increased; utilization of VT ablation in patients with ICD shocks and IHD increased; ICD implantation decreased in non-IHD patients and IHD patients; and admission for SCD was the strongest predictor of in-hospital mortality, followed by patients with non-IHD, patients with ICD shocks, and all patients with a Charlson comorbidity index ≥2. CONCLUSION:We report a decrease in admissions for VA, decreased ICD utilization, a change in pattern of VT ablation utilization, and an increase of in-hospital mortality in SCD patients. Predictors of adverse outcomes identified in our study should be considered when developing risk models for patients undergoing risk assessment for SCD.

journal_name

Heart Rhythm

journal_title

Heart rhythm

authors

Viles-Gonzalez JF,Arora S,Deshmukh A,Atti V,Agnihotri K,Patel N,Dave M,Anter E,Garcia F,Santangeli P,Goldberger JJ,Dukkipati S,d'Avila A,Natale A,Di Biase L

doi

10.1016/j.hrthm.2018.09.007

subject

Has Abstract

pub_date

2019-03-01 00:00:00

pages

358-366

issue

eissn

1547-5271

issn

1556-3871

pii

S1547-5271(18)30919-6

journal_volume

pub_type

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Outcomes of patients admitted with ventricular arrhythmias and sudden cardiac death in the United States.