Ventricular Arrhythmia Mortality in Patients With Heart Failure in the United States: Are There Differences Based on Race and Geography?
Document Type
Conference Proceeding
Publication Date
5-2024
Publication Title
Heart Rhythm
Abstract
Background: The progression of heart failure (HF) is associated with detrimental myocardial structural changes, predisposing HF patients to an increased risk of ventricular arrhythmia (VA). Despite advances in HF and VA management, real-world data assessing the VA-related mortality trends and disparities among patients with HF remain scarce. Objective: This study sought to determine the longitudinal trends and disparities in mortality attributed to VA with comorbid HF in the U.S. Methods: We queried the CDC WONDER database and performed serial cross-sectional analyses of national death certificate data for VA mortality with comorbid HF among patients aged ≥25 years. Ventricular tachycardia (I47.2) and ventricular fibrillation (I49.0) were listed as the underlying cause of death, and HF (I11.0, I13.0, I13.2, I50) was stated as the contributing cause of death. We calculated age-adjusted mortality rates (AAMR) per 1,000,000 individuals and determined the trends over time by using the Joinpoint Regression Program. Results: Between 1999 and 2000, a total of 3,514 deaths related to VA with comorbid HF were identified. The AAMR from VA with comorbid HF increased from 0.62 (95%CI, 0.50-0.73) in 1999 to 1.06 (95%CI, 0.94-1.19) in 2020, with an annual percent change of 3.39 (95%CI, 2.07-4.73). Overall, cumulative AAMR was higher in males than females (1.09 [95%CI, 1.04-1.13] vs. 0.49 [95%CI, 0.470-0.52]). African Americans had the highest AAMR (1.24 [95% CI, 1.14-1.35]) compared to other racial groups. In terms of geographic location, rural regions had a higher AAMR than urban regions (0.81 [95%CI, 0.75-0.88] vs. 0.70 [95%CI, 0.68-0.73]). The South region had the highest AAMR (0.86 [95%CI, 0.8 -0.90]), followed by the Midwest (0.80 [95%CI, 0.75-0.85]), Northeast (0.62 [95%CI, 0.57-0.67]), and West region (0.56 [95%CI, 0.51-0.61]). Conclusion: Our study reveals an increase in VA-related mortality with comorbid HF, with disparities seen in African Americans and rural regions. It underscores the necessity for actions to improve the mortality outcomes and narrow the healthcare inequalities.
Volume
21
Issue
5S
First Page
S707
Last Page
S708
Recommended Citation
Tan MC, Yeo YH, San BJ, Lee JZ, Tamirisa KP, Cha YM, et al. Ventricular arrhythmia mortality in patients with heart failure in the United States: are there differences based on race and geography? Heart Rhythm. 2024 May;21(5S):S707-S708. doi: 10.1016/j.hrthm.2024.03.1724
DOI
10.1016/j.hrthm.2024.03.1724
Comments
Heart Rhythm Society Annual Meeting, May 16-19, 2024, Boston, MA