Correlates of cardiac and sudden death after ambulatory monitoring in a community hospital. Importance of clinical characteristics, congestive heart failure and tachyarrhythmias.

To analyze the prognostic importance of arrhythmias on routine 24-hour ambulatory monitoring, we prospectively followed 755 consecutive patients undergoing monitoring at a community hospital in the context of usual medical care. Of the 755 patients, 114 (15%) had ventricular tachycardia on monitoring. At a mean follow-up of 38 months, multivariate survival analysis indicated that congestive heart failure was the strongest correlate of death from all causes (relative risk (RR) = 2.6), cardiac death (RR = 3.5), and the sudden cardiac death (RR = 5.6); ventricular tachycardia was significantly correlated with death from all causes and with cardiac death, but had only a borderline association with sudden cardiac death (RR = 1.9, p = 0.08). While ventricular tachycardia on ambulatory monitoring is of prognostic importance, congestive heart failure, as determined by routine clinical examination, was a more powerful prognostic correlate of deaths from all causes, death from cardiac causes, and sudden cardiac death.