Background: This study evaluates the prognostic impact of age on patients presenting with ventricular tachyarrhythmias (VTA) and aborted cardiac arrest.

Methods: The present longitudinal, observational, registry-based, monocentric cohort study included all consecutive patients presenting at the University Medical Center Mannheim (UMM) between 2002 and 2016 with ventricular tachycardia (VT), ventricular fibrillation (VF) and aborted cardiac arrest. Only patients 40 years old and older were included. Middle-aged (40–60 years old) were compared to elderly patients (> 60 years old). The primary endpoint was all-cause mortality at 2.5 years. The secondary endpoints were cardiac death at 24 hours, all-cause mortality at index hospitalization, all-cause mortality after index hospitalization and the composite endpoint at 2.5 years of cardiac death at 24 hours, recurrent VTA, and appropriate implantable cardioverter-defibrillator (ICD) therapies.

Results: A total 2,259 consecutive patients were included (28% middle-aged, 72% elderly). VT was more common among elderly patients (50% vs. 59%, p = 0.001), whereas VF was more common among middle-aged patients (50% vs. 41%, p = 0.001). Middle-aged patients had higher rates of cardiopulmonary resuscitation (CPR), due mainly to out-of-hospital CPR (35% vs. 25%, p = 0.001), whereas elderly had higher rates of in-hospital CPR (15% vs. 22%, p = 0.001). Elderly patients were more often associated with all-cause mortality at 2.5 years (27% vs. 50%; HR = 2.137; 95% confidence interval [CI] 1.809–2.523, p = 0.001), cardiac death at 24 hours (13% vs. 21%, p = 0.001), all-cause mortality at index hospitalization (21% vs. 35%, p = 0.001), all-cause mortality after index hospitalization (15% vs. 33%, p = 0.001) and the composite endpoint at 2.5 years (24% vs. 34%; HR = 1.471; 95% CI 1.230–1.759, p = 0.001). Adverse prognosis in elderly patients was demonstrated by multivariate Cox regression analyses and propensity score matching. Chronic kidney disease (CKD), systolic left ventricular function (LVEF) < 35%, CPR and cardiogenic shock worsened prognosis for both age groups, whereas acute myocardial infarction (STEMI/NSTEMI) and the presence of an ICD improved prognosis.

Conclusion: Elderly patients presenting with VTA and aborted cardiac arrest on admission were independently associated with adverse prognosis for all-cause mortality at 2.5 years, cardiac death at 24 hours, and the composite endpoint at 2.5 years.