In‐hospital ventricular arrhythmia in heart failure patients: 7 year follow‐up of the multi‐centric HEARTS registry

Abstract

Aims The aim of this study was to determine the incidence, predictors, and short-term and long-term outcomes associated with in-hospital sustained ventricular tachycardia (VT) and ventricular fibrillation (VF) collectively termed ventricular arrhythmia (VA) in the heart failure (HF) patients. of in-hospital cardiac events, prognosis, and outcome were monitored during the 7 year follow-up period. The incidence of in-hospital VA in HF was 4.2%. VA was more common among men, and mean age was lesser than non-VA patients (58.5 ± 16: 61.5 ± 15 years; P = 0.042). Smoking and family history of cardiomyopathy were significant risk factors of VA. Previous history of arrhythmia, ST elevated myocardial infarction, infections, and hypotension remained significant predictors of in-hospital VA associated with three to seven times more risk. Patients with VA had higher rates of in-hospital events like recurrent HF, haemodialysis, shock, sepsis, major bleeding, intra-aortic balloon pump, and stroke compared with those without VA, all being highly significant (P < 0.001). After adjustment for age, gender, and co-morbidities, in-hospital VA increased the risk of cardiogenic shock by 24 times, dialysis and major bleeding by 10 times, and recurrent congestive HF and pacing by five times. Survival analysis showed that all-cause mortality was significantly higher in the VA patients (P < 0.001). Presence of VA increased in-hospital and 1 month mortality to 23 and 17 times, respectively. Conclusions Lower mean age of VA complicated HF patients is a matter of concern in the Saudi population. HF associated with VA increased in-hospital events and all-cause mortality indicating poor prognosis and survival. These findings enable risk stratification and reflect on the importance of early recognition of the clinical markers and predictors of VA prompting immediate management.

Sex Differences in Heart Failure Mortality with Preserved, Mildly Reduced and Reduced Ejection Fraction: A Retrospective, Single-Center, Large-Cohort Study

“…Likewise, mortality from ventricular arrhythmias in ischemic cardiomyopathy is higher in men than in women. HF associated with ventricular arrhythmia, which is more common in men, is associated with a worse prognosis and higher mortality [ 20 , 21 ]. These findings may explain the higher risk of death in men with HFrEF.…”

Desmosomal Junctions and Connexin-43 Remodeling in High-Pacing-Induced Heart Failure Dogs

“…Arrhythmias caused by heart failure (HF) remain a major clinical problem for which a complete solution has not been found. 1 Therefore, the arrhythmogenic substrates affected by HF need to be further defined. Numerous studies have shown that arrhythmogenic substrates include myocardial hypertrophy, fibrosis, ischemia, myocardial electrical remodeling, and neuroendocrine regulation, as well as desmosomal and gap junction remodeling.…”

Silenced SOX2‐OT alleviates ventricular arrhythmia associated with heart failure by inhibiting NLRP3 expression via regulating miR‐2355‐3p

“…Chronic heart failure (HF) is the end‐stage manifestation of cardiovascular disease, which is mainly caused by hypertension, cardiomyopathy, as well as coronary and valvular heart diseases 1 . The rate of sudden death among patients with HF is six‐ to ninefold that of the general population, and 50%–70% of sudden cardiac deaths are due to malignant ventricular arrhythmias (VA) including tachycardia and fibrillation 2,3 . The main cause of death among patients with heart disease is VA, which needs to be resolved through appropriate investigation.…”