The impact of arrhythmias in acute heart failure.

Journal Article (Clinical Trial;Journal Article)

BACKGROUND: Arrhythmias are common in chronic heart failure and affect outcomes. The incidence and significance of new arrhythmias in acute heart failure, however, are largely unknown. METHODS AND RESULTS: The Outcomes of a Prospective Trial of Intravenous Milrinone for Exacerbations study randomized 949 patients with decompensated heart failure to receive intravenous milrinone or placebo. In the study, patients were divided into 2 groups based on the occurrence of a new arrhythmic event during their index hospitalization and analyzed for outcome. There were 59 new arrhythmic events occurring in 6% of the population. Of these, 49% were atrial fibrillation/flutter. The primary endpoint of days hospitalized for cardiovascular causes within 60 days after randomization was 30.9+/-22.7 for those in the arrhythmia group and 11.3+/-12.7 days for those with no arrhythmias (P=.0001). Mortality during index hospitalization was 26% in the arrhythmia group and 1.8% in the no arrhythmia group (P=.001). Death or hospitalization at 60 days was also worse in the arrhythmia group (35 versus 8.2%, P=.0001; 57 versus 34%, P=.001, respectively). Cox proportional hazard analysis identified new arrhythmias as an independent risk factor for the primary endpoint and death at 60 days. CONCLUSION: New arrhythmia during an exacerbation of heart failure identifies a high-risk group with higher intrahospital and 60-day morbidity and mortality.

Full Text

Duke Authors

Cited Authors

  • Benza, RL; Tallaj, JA; Felker, GM; Zabel, KM; Kao, W; Bourge, RC; Pearce, D; Leimberger, JD; Borzak, S; O'connor, CM; Gheorghiade, M; OPTIME-CHF Investigators,

Published Date

  • August 2004

Published In

Volume / Issue

  • 10 / 4

Start / End Page

  • 279 - 284

PubMed ID

  • 15309692

International Standard Serial Number (ISSN)

  • 1071-9164

Digital Object Identifier (DOI)

  • 10.1016/j.cardfail.2003.12.007


  • eng

Conference Location

  • United States