National Trends in Arrhythmias and Heart Failure Related Mortality in the United States From 1999 to 2023: A CDC Wonder Analysis.

Background: Arrhythmias are an important contributing cause of death in patients with heart failure (HF). Despite advancements in cardiovascular care, the burden of arrhythmia-related mortality in HF patients remains a significant public health concern. This study aims to evaluate national trends in arrhythmia-related mortality in HF patients from 1999 to 2023. Methods: Mortality data for patients with arrhythmias (ICD-10 codes: I44.0-I49.9) and HF (ICD-10 codes: I11.0, I13.0, I13.2, I50.0, I50.1, and I50.9) was obtained from the CDC WONDER Database. Age-adjusted mortality rates (AAMRs) were calculated per 100 000 populations. Joinpoint regression was used to assess the annual percentage changes in AAMR. Results: Between 1999 and 2023, arrhythmias and HF were responsible for 1 428 953 deaths in the United States. A notable increase in arrhythmia-related mortality among HF patients during 2018-2021 (APC = 5.77%) was observed. Sex-based disparities revealed higher mortality (AAMR: 37.61) in males. Racial and ethnic disparities were evident, with non-Hispanic American Indians showing the highest AAPC (2.95). State-level variations indicated that Oregon reported the highest AAMR (47.106), while Nevada reported the lowest (16.74). Geographic analysis showed higher mortality rates in non-metropolitan areas. Conclusion: The observed reduction in arrhythmia-related mortality in HF patients over the last two decades suggests promising advancements in public health strategies and cardiovascular care. However, the persistent disparities across geographic, demographic, and healthcare access lines underscore the need for deeper investigation into the underlying causes of these trends.