In-hospital Mortality in a Large Seven Year Single-center Retrospective Cohort of Patients Admitted for Ventricular Arrhythmia

Q: What are the key findings of this study?

Catheter ablation for ventricular arrhythmia was associated with a significantly reduced in-hospital mortality of 1% compared to 25% with conservative treatment (OR 0.12, 95% CI 0.05–0.32, p < 0.001).

Q: What is the clinical evidence from this study?

Study design: Observational. Population: ventricular arrhythmia without ST-segment elevation myocardial infarction (n=2514). Intervention: catheter ablation for ventricular arrhythmia vs. conservative management. Primary outcome: in-hospital mortality (OR 0.12, 95% CI 0.05-0.32, p=<0.001).

Q: What does this research mean for the field?

Catheter ablation and antiarrhythmic drug therapy are associated with reduced in-hospital mortality in patients admitted for ventricular arrhythmia, while the occurrence of ventricular fibrillation and cardiogenic shock are associated with increased mortality risk. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.SUPPORTS_CONSENSUS.

Q: What question did this study set out to answer?

The study aims to identify factors associated with in-hospital mortality in patients admitted for ventricular arrhythmia.

Jannis Dickow; Nele Geßler; Johannes Feldhege; Zeynep Demirtakan; Borislav Dinov; Melanie Gunawardene; T Harloff; Ilaria My; Samuel Sossalla; Julia Vogler; Rahin Wahedi; Peter Wohlmuth; Stephan Willems; Arian Sultan

doi:10.1016/j.hroo.2026.02.012

February 1, 2026Heart Rhythm O2Open Access

In-hospital Mortality in a Large Seven Year Single-center Retrospective Cohort of Patients Admitted for Ventricular Arrhythmia

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Key result

Catheter ablation for ventricular arrhythmia is linked to ~88% lower in-hospital mortality versus conservative treatment.

OR 0.12
95% CI 0.05-0.32
P<0.001
n=2,514

Figures

Graphical abstract published by Heart Rhythm O2 — Graphical abstract · Published by Heart Rhythm O2 · CC BY-NC-ND

Why the study?

Patients admitted for ventricular arrhythmia face severe deterioration and mortality, prompting an investigation into factors associated with in-hospital mortality.

Does catheter ablation or antiarrhythmic drug therapy reduce in-hospital mortality in patients admitted for ventricular arrhythmia?

Key Points

The study aims to identify factors associated with in-hospital mortality in patients admitted for ventricular arrhythmia.
Retrospective analysis of consecutive patients admitted for ventricular arrhythmia from 2017 to 2024.
Exclusion of patients with acute ST-segment elevation myocardial infarction.
Logistic regression models used to identify mortality-associated factors.
Analyzed 2,514 patients with a mean age of 65 years and an in-hospital mortality rate of 20%.
Catheter ablation and antiarrhythmic therapy correlated with reduced mortality.
Occurrence of ventricular fibrillation and cardiogenic shock significantly increased mortality risk.

Study Design

Type

Observational (n=2,514)

Multicenter

No

Structured PICO

Does catheter ablation or antiarrhythmic drug therapy reduce in-hospital mortality in patients admitted for ventricular arrhythmia?

P

Population

2,514 consecutive patients admitted for ventricular arrhythmia (premature ventricular contractions in the setting of structural heart disease, ventricular tachycardia, and/or ventricular fibrillation/flutter) between 2017 and 2024. Excluded: acute ST-segment elevation myocardial infarction. Mean age 65±13 years, 22% female.

I

Intervention

Catheter ablation and/or antiarrhythmic drug therapy

C

Comparator

Conservative treatment / absence of catheter ablation or antiarrhythmic drug therapy

O

Outcome

In-hospital mortalityhard clinical

Main Result

Effect estimate: OR 0.12 (95% CI 0.05-0.32)

Absolute Event Rate: 1% vs 25%

p-value: p=<0.001

In patients hospitalized for ventricular arrhythmia, treatment with catheter ablation or antiarrhythmic drugs is associated with significantly lower in-hospital mortality, while presentation with VF or cardiogenic shock strongly predicts death.

Limitations

Single-center observational study design
Data based on hospital billing codes without individual chart review
Potential coding errors and misclassification
Lack of clinical granularity (no data on electrical storm, arrhythmia burden, sedation strategies)
No precise timing for catheter ablation relative to clinical instability
No data on cause of death
Lack of randomization and potential residual confounding
Selection bias for therapy as catheter ablation was based on clinical judgment
Potential immortal time bias (patients must survive to undergo catheter ablation)
Pooling of different ventricular arrhythmia types introduces heterogeneity
Findings may not generalize beyond single institution
No information on prior catheter ablations or procedural details
No long-term follow-up data on ablation safety, efficacy, or mortality

Implication

Supports ablation consideration in ventricular arrhythmia admissions; hypothesis-generating pending randomized confirmation.

Abstract

Abstract Background Patients admitted for ventricular arrhythmia (VA) are at risk for severe deterioration and mortality. Objective The aim of this study was to identify factors associated with in-hospital mortality in patients treated for VA. Methods Consecutive patients admitted for VA (premature ventricular contractions in the setting of structural heart disease, ventricular tachycardia, and/or ventricular fibrillation/flutter [VF]) between 2017 and 2024 were retrospectively analyzed. Patients with VA suffering from acute ST-segment elevation myocardial infarction were excluded. The primary outcome was in-hospital mortality. Logistic regression models were used to identify factors associated with the primary outcome in-hospital mortality. Results In total, 2,514 patients with VA were analyzed: mean age 65±13 years, 22% female, 59% ischemic cardiomyopathy, 23% non-ischemic cardiomyopathy, mean left ventricular ejection fraction 38±13%. The overall in-hospital mortality rate was 20%. Catheter ablation (CA) for VA was performed in 20% of patients who were younger, and had lower rates of acute heart failure than patients who were treated conservatively. Antiarrhythmic drug therapy (OR 0.39, 95% CI 0.28-0.54), and CA for VA (OR 0.12, 95% CI 0.05-0.32) independently correlated with reduced in-hospital mortality, while the occurrence of VF (OR 2.78, 95% CI 2.03-3.78), and cardiogenic shock (OR 4.08, 95% CI 2.91-5.72) correlated with an increased risk for in-hospital mortality. Conclusion In-hospital mortality among patients hospitalized for VA was 20%. Factors correlated with reduced in-hospital mortality included CA and antiarrhythmic drug therapy. The occurrence of VF, and cardiogenic shock were correlated with increased in-hospital mortality.

Discussion

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Cite This Study

Dickow et al. (2026) conducted an observational in ventricular arrhythmia without ST-segment elevation myocardial infarction (n=2,514). catheter ablation for ventricular arrhythmia vs. conservative management was evaluated on in-hospital mortality (OR 0.12, 95% CI 0.05-0.32, p=<0.001). Catheter ablation for ventricular arrhythmia was associated with a significantly reduced in-hospital mortality of 1% compared to 25% with conservative treatment (OR 0.12, 95% CI 0.05–0.32, p < 0.001).

synapsesocial.com/papers/69994b41873532290d01f63d https://doi.org/10.1016/j.hroo.2026.02.012

Topics

Ventricular arrhythmias

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In-hospital Mortality in a Large Seven Year Single-center Retrospective Cohort of Patients Admitted for Ventricular Arrhythmia

Figures

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

Topics

In-hospital Mortality in a Large Seven Year Single-center Retrospective Cohort of Patients Admitted for Ventricular Arrhythmia

Figures

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

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