Trends in Ventricular Tachycardia Admissions and Emergency Department Charges in the United States

Ventricular tachycardia (VT) is a potentially life-threatening cardiac arrhythmia that frequently prompts emergency department (ED) evaluation. This study aims to analyze national trends, patient characteristics, comorbidities, admission and ED charges among VT encounters in the United States.

We conducted a descriptive retrospective epidemiological analysis of a nationally representative ED visits data from 2016-2022 utilizing the Nationwide Emergency Department Sample (NEDS) database. Adults presenting with VT were identified using ICD-10 diagnosis code “I472”. The primary outcome was emergency department mortality among patients presenting with ventricular tachycardia. Secondary outcomes included temporal trends in VT encounters, comorbidity prevalence, hospital admission, survival, and ED charges. We constructed a survey-weighted multivariable regression model to identify factors associated with ED mortality among VT patients.

From 2016-2022, a total of 2.57 million encounters for VT were identified. Patients had a mean age of 68.4 (± 14) years, and 34% were female. The frequency of annual VT encounters increased from 297,543 in 2016 to a peak of 432,643 in 2021, representing a 45% rise, and subsequently decreased to 331,131 in 2022, a decline of approximately 23%. Concerning comorbidities including hypertension were reported in 68% of cases, while coronary artery disease and congestive heart failure were present in 52.0% and 57.3% of cases, respectively. The prevalence of congestive heart failure among VT encounters increased from 45.3% in 2016 to 61.4% in 2022. Most VT ED encounters resulted in hospital admission in 87% with a survival rate of 89%. ED mortality was low, occurring in 0.6% of total encounters. Mean ED charges per VT encounter increased from $4,400 in 2016 to $7,000 in 2022. VT patients had higher ED mortality when presenting with acute myocardial infarction (RR 1.90, 95% CI 1.85–1.95, p < 0.001) or venous thromboembolism (RR 1.75, 95% CI 1.68–1.81, p < 0.001), as well as stroke/TIA, diabetes, CKD, uninsured status, female sex, and older age (all p < 0.001).

VT ED encounters have increased over time and involve a co-morbid population with low ED mortality and rising ED annual visits, highlighting the growing emergency care burden of VT.