Understanding the Mortality Trends in Patients With Ventricular Arrhythmias and Cardiomyopathy: A 25-Year Retrospective Analysis From 1999-2024

BACKGROUND: Ventricular Arrhythmias (VA) associated with Cardiomyopathy (CM) continues to be the major cause of death. However, a national longitudinal study examining mortality trends from these conditions is still lacking. This study assessed mortality trends due to these conditions among U.S. adults aged ≥ 25 years from 1999 to 2024. METHODS: An observational analysis of U.S. mortalities due to VA in patients with CM (ICD-10 I47.2, I49.0 and I25.5, I42 respectively), was conducted using CDC WONDER. Adjusted Mortality Rates (AAMR) per 100,000 calculated and trends were assessed by calculating Average and Annual Percent Change (AAPC, APC), using joinpoint regression stratified by year, sex, race, and region. RESULTS: From 1999 to 2024, 81,204 VA with CM-related deaths occurred with the overall AAMR declined from 2.54 in 1999 to 1.01 in 2024 (AAPC: -3.55%; p < 0.000001). AAMRs decreased from 1999 to 2007 (APC: -7.93), remained stable till 2022 (APC: -0.66), and dropped by 2024 (APC: -6.87). Men exhibited greater AAMRs (2.42) than women (0.68). Racially, the AAMRs were most pronounced in Non-Hispanic (NH) Blacks (1.97), followed by NH Whites (1.42), whereas Hispanics and NH Others experienced similar AAMRs of 0.97. Geographically, Delaware and the Western regions experienced the highest rates of mortality (2.2 and 1.53, respectively). Urban areas had higher AAMRs than rural settings (1.45 vs. 1.4) CONCLUSION: Although VA-CM mortality has declined over the past two decades, differences by race, sex, and geography remain, underscoring the need for targeted healthcare strategies.