Prevalence of arrhythmias and device therapy in hospitalized patients with HFpEF: a single-center retrospective cohort
A Bondoc, D D Anutoni, A M Bumbar, A A Faur-Grigori, S A Luca, L Cirin, C T Luca, D Cozma, S Crisan, C VacarescuAbstract
Background
Arrhythmias and conduction disorders are frequently encountered in patients with heart failure with preserved ejection fraction (HFpEF) and may contribute to clinical complexity and the need for device therapy. However, real-world data describing the arrhythmic profile of hospitalized HFpEF patients remain limited.
Purpose
To describe the prevalence of atrial and ventricular arrhythmias, conduction disorders, and cardiac device implantation in patients hospitalized with HFpEF at a tertiary care center.
Methods
We conducted a retrospective observational cohort study including all patients hospitalized at our institution during 2024 with a diagnosis of HFpEF. Arrhythmic events documented during hospitalization were analyzed, including atrial arrhythmias, ventricular arrhythmias, and conduction disorders. The prevalence of permanent pacemaker and implantable cardioverter-defibrillator (ICD) implantation was recorded. Data are presented using descriptive statistics.
Results
A total of 2.920 patients with HFpEF were included (1.569 males, mean age 71.1 ± 9.4 years). Supraventricular arrhythmias were documented in 843 patients (28.9%), predominantly atrial fibrillation, atrial flutter, or atrial tachycardia. Ventricular arrhythmias were less frequent, occurring in 44 patients (1.5%), including non-sustained ventricular tachycardia, sustained ventricular tachycardia, or ventricular fibrillation. Conduction disorders were identified in 473 patients (16.2%), mainly atrioventricular block or sick sinus syndrome. Among these, 457 patients underwent permanent pacemaker implantation, while 20 patients received an ICD, most commonly in the presence of associated coronary artery disease.
Conclusions
In this large real-world cohort of hospitalized patients with HFpEF, atrial arrhythmias and conduction disorders were common, whereas ventricular arrhythmias were relatively infrequent. A substantial proportion of patients required device therapy, predominantly permanent pacing. These findings highlight the arrhythmic complexity of HFpEF in the inpatient setting and support the need for further studies to refine arrhythmic risk stratification and management strategies in this heterogeneous population.