Abstract
Arrhythmia is a common finding in heart failure patients. It has a greater impact on prognosis in those patients, especially ventricular arrhythmia type. Although there are some studies about PVCs and NSVT in heart failure, few data are available regarding sustained VT/VF in heart failure. In this study, our aim was to investigate the incidence of sustained VT/VF, the factors associated with its occurrence and prognosis in hospitalized heart failure patients.We hypothesized that heart failure patients are prone to develop ventricular arrhythmia which can adversely affect the prognosis.Prospective study of 2610 patients admitted in 18 government hospitals with HF between October 2009 and December 2010. Patients were categorized as having ventricular arrhythmia (VA) if they experienced either sustained ventricular tachycardia (VT) or ventricular fibrillation (VF) or both during hospitalization.Of 2610 patients with HF enrolled in the HEARTS registry, 110 (4.2%) were diagnosed with VA. The vast majority (97%) occurred in patients with heart failure with reduced ejection fraction (HFrEF). Factors associated with an increased risk of developing VA during hospitalization for HF are arrhythmia (OR 8.2; 95% CI 3.3-20.4), STEMI (OR 2.6; 95% CI 1.1–6.3) as precipitating factors for HF, and systolic blood pressure <90mmHg at presentation (OR 3.1; 95% CI 1.3–7.4). Adverse in-hospital outcomes including recurrent HF, hemodialysis, shock, sepsis, major bleeding, intra-aortic balloon pump (IABP) and pacing were higher for patients with VA (P⩽.001 for all comparisons) and signified a poor prognosis. The in-hospital, 30-days, 1-year, 2-year, and 3-year mortality rates were significantly higher in VA patients compared with non-VA patients (P⩽.001 for all comparisons). VA was found in a small percentage of hospitalized heart failure patients. However, it was associated with remarkably high rates of adverse events and increased mortality rate. Information from patient’s medical history and clinical presentation parameters can predict VA development in HF patients. Evaluating those associated factors would help isn identifying patients at high risk for VA.