Trends and In‐Hospital Outcomes of Ventricular Tachycardia in Ischemic Versus Non‐Ischemic Dilated Cardiomyopathy—An Insight From the Nationwide Readmissions Database (2016–2020)

Background Ventricular tachycardia (VT) is a major cause of morbidity and mortality in patients with structural heart disease, yet real‐world comparisons between ischemic cardiomyopathy (ICM) and non‐ischemic dilated cardiomyopathy (NIDCM) remain limited. Methods The national readmission database (2016–2020) was used to identify hospitalizations for VT. Cohorts were stratified based on underlying cardiomyopathy. A Propensity Score Matching (PSM) model matched ICM to NIDCM patients. Pearson's x2 test was applied to PSM‐matched cohorts to compare outcomes. Results We identified 622,092 VT hospitalizations, of which 575,312 (92.4%) had ICM and 46,780 (7.5%) had NIDCM. Outcomes were compared using multivariable logistic regression and propensity score matching (25,919 matched pairs). Despite being younger, NIDCM patients had higher in‐hospital mortality (10.4% vs. 9.6%, p < 0.001; aOR 1.08), stroke (1.7% vs. 1.2%, aOR1.42), acute heart failure (65% vs. 59%, aOR 1.36), acute kidney injury (46.1% vs. 41.7%, aOR1.35), endotracheal intubation (13.1% vs. 14.5%, aOR 1.06), ICD implantation (3.9% vs. 3.5%, aOR1.23), and VT ablation (1.0% vs. 0.5%, aOR1.76). Readmission rates were significantly higher in NIDCM at 30 days (10.4% vs. 8.7%, p = 0.019), 90 days (22.7% vs. 20.0%, p = 0.483), and 180 days (30.7% vs. 27.3%, p = 0.001). In contrast, ICM patients had higher rates of sudden cardiac arrest (10.6% vs. 5.9%, aOR0.55), major adverse cardiovascular events (78.9% vs. 52.2%, aOR0.24), cardiogenic shock (18.4% vs. 12.1%, aOR0.59), ECMO (0.9% vs. 0.4%, aOR0.48), and LVAD use (0.5% vs. 0.3%, aOR0.58). Mortality declined over time in ICM (8.5% in 2016 to 8.2% in 2020, p ‐trend = 0.006), but not in NIDCM. Conclusion These findings highlight distinct clinical profiles and emphasize the need for targeted management strategies for VT based on the cardiomyopathy subtype.