Open AccessFrequent premature ventricular contractions. Association of burden and complexity with prognosis according to the presence of structural heart disease
Author(s) -
Parreira Leonor,
Marinheiro Rita,
Amador Pedro,
Mesquita Dinis,
Farinha Jose,
Lopes Artur,
Fonseca Marta,
Chambel Duarte,
Venancio Jose,
Lopes Claudia,
Caria Rui
Publication year - 2021
Publication title -
annals of noninvasive electrocardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.494
H-Index - 48
eISSN - 1542-474X
pISSN - 1082-720X
DOI - 10.1111/anec.12800
Subject(s) - medicine , cardiology , hazard ratio , heart failure , quartile , ventricular tachycardia , sudden cardiac death , incidence (geometry) , heart disease , premature atrial contraction , proportional hazards model , atrial fibrillation , confidence interval , physics , optics
Premature ventricular contractions (PVC) have been associated with mortality and heart failure (HF) regardless the presence of structural heart disease (SHD). The aim of this study was assessing the impact of burden and complexity of PVCs on prognosis, according to presence of SHD. Methods 312 patients were retrospectively evaluated out of 1967 consecutive patients referred for 24‐hr Holter at a single hospital, with a PVC count >1% of total beats. Two groups with and without SHD. PVC burden (PVC%), presence of complex forms, incidence of all‐cause death, combined outcomes of all‐cause death and cardiovascular hospitalizations, HF death and HF hospitalizations and, sudden death (SD) or hospitalizations due to ventricular arrhythmias (VA)were assessed. Results Premature ventricular contraction burden was 2.7 (IQR: 1.6–6.7). SHD patients had more polymorphic PVCs, 77% versus 65%, p = .022, triplets and episodes of non‐sustained ventricular tachycardia (NSVT): 44% versus 27%, p = .002; 30% versus 12%, p < .0001. In idiopathic patients, a PVC% in the third quartile was independently associated with all‐cause mortality hazard ratio (HR) 2.288 (1.042–5.026) p = .039, but not in SHD. The complexity of the PVCs was not independently associated with outcomes in both groups. In SHD group, NSVT was associated with lower survival free from SD and VA hospitalizations, p = .028; after multivariable, there was a trend for a higher arrhythmic outcome with NSVT, HR 3.896 (0.903–16.81) p = .068. Conclusion Premature ventricular contractions in SHD showed more complex patterns. In idiopathic patients, a higher PVC count was associated with higher mortality but not is SHD patients. Complexity was not independently associated with worse prognosis.