Key result
Arrhythmia-related CHD mortality dropped ~29% since 1999, but progress stalled after 2012.
Why the study?
Arrhythmias remain a major cause of death in patients with congenital heart disease, but population-based trends in arrhythmia-related mortality associated with CHD are not well defined.
Observational (n=24,711)
Yes
Absolute Event Rate: 0.42% vs 0.3%
While overall arrhythmia-related mortality in CHD patients declined from 1999 to 2024, mortality rates are increasing in older adults (≥55 years), highlighting a growing high-risk population.
Rising arrhythmia mortality in older CHD adults warrants closer monitoring; leaves open whether age-targeted strategies can reverse trends.
BACKGROUND: Improved medical care has increased survival for patients with congenital heart disease (CHD), but arrhythmias remain a major cause of death. Population-based trends in arrhythmia-related mortality associated with CHD are not well defined. OBJECTIVES: This study aimed to evaluate population-based trends and disparities in arrhythmia-related mortality involving CHD as a contributing cause of death in the United States from 1999 to 2024. METHODS: This retrospective analysis used multiple cause-of-death records from the CDC (Centers for Disease Control and Prevention) WONDER (Wide-ranging Online Data for Epidemiologic Research) database to examine long-term trends and disparities in arrhythmia-related mortality associated with CHD from 1999 to 2024. Age-adjusted mortality rates (AAMRs) were calculated by sex, age, race/ethnicity, census region, and urbanization level. Trends were evaluated using Joinpoint regression. Exploratory ARIMA (Autoregressive Integrated Moving Average) projections were generated through 2034. RESULTS: From 1999 to 2024, 24,711 arrhythmia-related deaths involving documented CHD were identified. The overall AAMR declined from 0.42 in 1999 to 0.30 in 2024. Males had consistently higher mortality. All racial groups showed declines, but non-Hispanic Black individuals had the highest rates. Large metropolitan areas experienced the most rapid decline, while rural areas had persistently elevated mortality. Infants had the highest mortality, while ages 15 to 24 showed the fastest decline. In contrast, adults ≥55 years of age demonstrated increasing mortality beginning in the mid-2000s, most prominently in those 75-84 years of age. Exploratory projections suggest overall AAMR will stabilize around 0.30 through 2034, with continued increases in the 75-84-year group. CONCLUSIONS: Arrhythmia-related mortality associated with CHD declined over 26 years, but progress has stalled or reversed since 2012, especially among the elderly, certain regions, and racial groups.
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Chenyue et al. (2026) conducted an observational in Congenital heart disease and arrhythmias (n=24,711). Time period (1999-2024) was evaluated on Age-adjusted mortality rate (AAMR). The overall age-adjusted mortality rate for arrhythmia-related deaths involving congenital heart disease in the US declined from 0.42 in 1999 to 0.30 in 2024, but progress has stalled since 2012.
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