Cardiac arrhythmias and conduction disorders are life-threatening emergencies, especially in older adults. Early recognition and rapid management are essential, relying on an initial evaluation that identifies patients at highest risk of adverse outcomes.This study aimed to determine the predictors of in-hospital mortality among patients aged 65 years and older admitted to the emergency department for arrhythmias and/or conduction disorders.A two-year prospective, descriptive, and analytical study was conducted. It included all patients aged ≥65 years managed in the emergency department for a documented cardiac rhythm or conduction disorder. Clinical presentation, comorbidities, therapeutic interventions, and in-hospital outcomes were collected. Univariate and multivariate logistic regression analyses were performed to identify factors associated with in-hospital mortality.A total of 102 patients were enrolled, with a mean age of 76±7 years and a sex ratio of 0.75. The most prevalent comorbidities were arterial hypertension(78.4%), previously known arrhythmias(48%), coronary artery disease(37.3%), heart failure(16.7%), and valvular heart disease(15.7%). The leading presenting symptoms included dyspnea(37.2%), fatigue(24.4%), chest pain(16.5%), palpitations(15.2%), and impaired consciousness (7.3%). Atrial fibrillation was the most frequently recorded arrhythmia(67.6%). The most common conduction disorders were atrioventricular blocks(12.7%) and sinoatrial blocks(6%). Congestive heart failure was present at admission in 20.7% of cases. The overall in-hospital mortality rate was 10%.In univariate analysis, mortality was associated with age ≥85years(OR=4.09;p<0.02), a history of ischemic stroke(OR=2.73;p<0.001), Glasgow Coma Scale<15 on admission(OR=5.13;p<0.01), and third-degree atrioventricular block(OR=2.17;p< 0.006). In multivariate analysis, two independent predictors of in-hospital mortality were identified:age≥85years(adjusted OR=7.07;p=0.008) and a history of ischemic stroke (adjusted OR=2.47;p=0.001).Our findings are consistent with those of Gaur et al.[1], who reported that a history of cerebrovascular disease predicts atrial fibrillation recurrence and poor overall prognosis. Advanced age (≥85years) also emerged as a strong mortality predictor, likely due to age-related structural and electrical cardiac remodeling and the accumulation of competing comorbidities. Similar conclusions were highlighted by Curtis et al.[2], who emphasized the impact of these age-related changes on disease evolution and therapeutic response.Arrhythmias and conduction disorders in older adults represent a major management challenge in emergency settings. Early identification of high-risk patients may improve triage and initial management thus ultimately reducing mortality.