The current study reveals trends, gender, age, racial, and geographical differences in mortality due to paroxysmal tachycardia. Up to the authors’ best knowledge, this is the first study to investigate these trends from 1999 to 2020 in the US population. Data obtained from the Centers for Disease Control and Prevention’s WONDER database The data comprised 155,320 deaths caused by paroxysmal tachycardia from 1999 to 2020. During the period of 1999 to 2008, there was a steady decline in mortality due to paroxysmal tachycardia. However, it was followed by a steady incline in mortality rate, reaching 10008 deaths in 2020, which is higher than deaths recorded in 1999, which accounted for 8387 cases. This finding could be attributed to the fact that cardiac arrhythmias has been documented as a potential complication of COVID-19 (13).

The trends in gender and age differences noted in our study signal a critical area for further investigation and intervention. Men had higher AAMRs as compared to women. This variation may result from differences in the risk of ischemic heart disease and variations in the susceptibility of different genders to arrhythmias (14). Gender differences have been associated with certain claims relating to hormones, where it has been documented that testosterone lowers the calcium release facilitated by ryanodine receptors and the sodium/calcium exchange current (14). Due to the opposite action of estrogen, women may be more susceptible to provocative activity (15, 16). On the contrary, estrogen is also known to be cardioprotective, as indicated by the decrease of cardiac cell death in cardiomyopathies while testosterone stimulates the production of inflammatory substances (17).

Regarding age groups, older adults had the highest AAMRs due to paroxysmal tachycardia compared to the middle and young adult age groups, which could be attributed to older adults having a higher number of comorbidities placing them at increased risk. Notably, there has been an increase in AAMR among all age groups in the last decade, which could be explained by the COVID-19 pandemic, as arrhythmias are potential complications, and also by increased accessibility to healthcare and improved technology, which eases diagnosis.

In the context of racial differences, the most significant mortality due to paroxysmal tachycardia was noted in the NH Black or African American group, followed by the NH Indian American racial population. Racial differences are most likely due to socioeconomic and environmental factors (18). This gap may be linked to recognized discrepancies in healthcare access and resources encountered by these minority communities (19). Such could include income and insurance differences, decreased access to healthcare, and the prevalence of unmanaged comorbidities, which could all act as risk factors for paroxysmal tachycardia and arrhythmias. Future research must therefore focus on exploring socioeconomic factors which could contribute to potential disparities. Moreover, this is also reinforced by previous evidence, which highlights greater COVID-19 infection rates and deaths within these groups (20).

Furthermore, we noticed in our study that the AAMR of paroxysmal tachycardia was higher in the non-metropolitan region compared to the metropolitan region; however, overall increases in mortality rates were noticed in both regions in the last decade. Due to their limited access to healthcare services, non-metropolitan areas may have seen a rise in the mortality gap between urban and rural areas (21). While telehealth is not appropriate for every patient, a study by Soliman et al. showed that it can be used to manage primary and secondary cardiovascular disease in a large patient population (22). Telehealth platforms can be utilized to follow up patients with comorbidities and ensure they are managed to mitigate their risk of complications.