Vol. 7, Issue 2, Part B (2025)

Background: Ventricular arrhythmias (VAs) encompass a wide spectrum of rhythm disorders ranging from premature ventricular contractions (PVCs) to sustained ventricular tachycardia (VT) and life-threatening ventricular fibrillation (VF). They are frequently associated with structural heart disease (SHD) and remain a major cause of morbidity and mortality. Despite their clinical importance, data on incidence and outcomes from real-world registries in developing countries are limited. Objectives: This study aimed to assess the incidence, risk factors, and outcomes of patients presenting with VAs at Tanta University Hospitals. Methods: This prospective observational registry included 400 consecutive patients presented with VAs. Clinical history, comorbidities, laboratory results, electrocardiogram (ECG), and echocardiographic data were systematically collected. Outcomes at 3 months included cardiac mortality, recurrence of VA, and heart-failure (HF) hospitalization. Results: The incidence of VAs among patients was 14% over two years. The cohort had a mean age of 53.0±15 years and 59% were male. During follow-up, cardiac mortality occurred in 28 patients (7%), VA recurrence in 62 patients (15.5%), and HF hospitalization in 47 patients (11.7%). In multivariate analysis, cardiac mortality was independently predicted by monomorphic VT (P=0.004; OR 4.16, 95% CI 1.57-11.04) and VF (P=0.003; OR 5.13, 95% CI 1.72-15.25). VA recurrence was strongly associated with a PVC burden >10% (P<0.001; OR 1.26, 95% CI 1.15-1.39). HF hospitalization was independently predicted by older age (P=0.020; OR 1.04, 95% CI 1.01-1.08), cardiogenic shock (P=0.045; OR 2.45, 95% CI 1.02-5.88), and non-LBBB morphology (P=0.011; OR 3.24, 95% CI 1.31-8.01). Conclusions: VA incidence was 14%. Mortality was driven by monomorphic VT and VF; VA recurrence by high PVC burden; and HF hospitalization by older age, cardiogenic shock, and non-LBBB. These factors can guide early risk stratification and follow-up.