Outcomes of Patients Admitted with Ventricular Arrhythmias and Sudden Cardiac Death in the United States.
Heart Rhythm. 2018 Sep 17;:
Authors: Viles-Gonzalez JF, Arora S, Deshmukh A, Atti V, Agnihotri K, Patel N, Dave M, Anter E, Garcia F, Santangelli P, Goldberger JJ, Dukkipati S, d'Avila A, Natale A, Di Biase L
BACKGROUND: mortality caused by ventricular arrhythmias (VA) remains a problem of epidemic proportions. Understanding current trends on admission of VA, patient characteristics, morbidity, mortality and healthcare utilization could help us improve allocation of healthcare resources and risk prediction.
OBJECTIVES: to investigate clinical outcomes of VA including VT, ICD shocks and SCD; to identify predictors of morbidity and mortality, patterns of utilization of ICD and VT ablation, and the impact of such metrics on overall healthcare utilization.
METHODS: from 2010-2015 we identified 290998 VA hospitalization, which were stratified in Group 1: Normal Heart; Group 2: ischemic heart disease (IHD), Group 3: non-ischemic heart disease (non-IHD); Group 4: ICD shocks; Group 5: sudden cardiac death (SCD - cardiac arrest without ICD shock).
RESULTS: the number of admissions for VA decreased during study period (except patients with SCD and ICD shock that 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 patients with non-IHD and IHD patients; 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.
CONCLUSIONS: we report a decrease in admissions for VA, decrease in 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 of SCD.
PMID: 30236610 [PubMed - as supplied by publisher]