Fluctuations in premature ventricular contraction burden can affect medical assessment and management.
Aged
Cohort Studies
Electrocardiography, Ambulatory
/ methods
Female
Follow-Up Studies
Humans
Male
Middle Aged
Retrospective Studies
Sensitivity and Specificity
Severity of Illness Index
Stroke Volume
/ physiology
Time Factors
Ventricular Dysfunction, Left
/ diagnostic imaging
Ventricular Premature Complexes
/ diagnostic imaging
Ablation
Ambulatory cardiac monitor
Arrhythmia
Left ventricular ejection fraction
PVC burden variability
Premature ventricular contraction (PVC)
Journal
Heart rhythm
ISSN: 1556-3871
Titre abrégé: Heart Rhythm
Pays: United States
ID NLM: 101200317
Informations de publication
Date de publication:
10 2019
10 2019
Historique:
received:
07
12
2018
pubmed:
21
4
2019
medline:
2
12
2020
entrez:
21
4
2019
Statut:
ppublish
Résumé
Frequent premature ventricular contractions (PVCs) can cause disabling symptoms and decrease left ventricular ejection fraction. PVC burden, typically quantified by a 24-hour monitor, is one of the factors that determines the clinical management of PVCs. The purpose of this study was to evaluate the extent of variability in 24-hour PVC burden during 14-day ambulatory cardiac monitoring in patients with significant PVC burden. All patients referred for PVC evaluation received a 14-day ambulatory cardiac monitor. Parameters of interest included mean 14-day PVC burden, minimum and maximum 24-hour PVC burden, and absolute change in 24-hour PVC burden (maximum minus minimum). We included only patients with a mean 14-day PVC burden of more than 5%. Fifty-nine patients were included in the study. The median of mean 14-day PVC burden, maximum 24-hour PVC burden, and minimum 24-hour PVC burden were 9.0% (IQR 6.4%-17.9%), 16.2% (IQR 11.7%-26.2%), and 4.5% (IQR 2.6%-11.2%) respectively (P < .001). The median of the absolute 24-hour PVC burden change was 9.9% (IQR 5.4%-14.5%). There was a 2.45-fold (IQR 1.68- to 5.55-fold) median difference between maximum 24-hour PVC burden and minimum 24-hour burden in the same patient. When categorized by low (<10%), intermediate (10%-20%), and high (>20%) 24-hour PVC burden, 72.9% patients fell into at least 2 categories depending on the 24-hour period considered. There is a significant variation in 24-hour PVC burden when measured over a 14-day period in patients with of PVC burden of more than 5%. This variation might impact critical clinical decisions in a significant proportion of such patients.
Sections du résumé
BACKGROUND
Frequent premature ventricular contractions (PVCs) can cause disabling symptoms and decrease left ventricular ejection fraction. PVC burden, typically quantified by a 24-hour monitor, is one of the factors that determines the clinical management of PVCs.
OBJECTIVE
The purpose of this study was to evaluate the extent of variability in 24-hour PVC burden during 14-day ambulatory cardiac monitoring in patients with significant PVC burden.
METHODS
All patients referred for PVC evaluation received a 14-day ambulatory cardiac monitor. Parameters of interest included mean 14-day PVC burden, minimum and maximum 24-hour PVC burden, and absolute change in 24-hour PVC burden (maximum minus minimum). We included only patients with a mean 14-day PVC burden of more than 5%.
RESULTS
Fifty-nine patients were included in the study. The median of mean 14-day PVC burden, maximum 24-hour PVC burden, and minimum 24-hour PVC burden were 9.0% (IQR 6.4%-17.9%), 16.2% (IQR 11.7%-26.2%), and 4.5% (IQR 2.6%-11.2%) respectively (P < .001). The median of the absolute 24-hour PVC burden change was 9.9% (IQR 5.4%-14.5%). There was a 2.45-fold (IQR 1.68- to 5.55-fold) median difference between maximum 24-hour PVC burden and minimum 24-hour burden in the same patient. When categorized by low (<10%), intermediate (10%-20%), and high (>20%) 24-hour PVC burden, 72.9% patients fell into at least 2 categories depending on the 24-hour period considered.
CONCLUSION
There is a significant variation in 24-hour PVC burden when measured over a 14-day period in patients with of PVC burden of more than 5%. This variation might impact critical clinical decisions in a significant proportion of such patients.
Identifiants
pubmed: 31004780
pii: S1547-5271(19)30362-5
doi: 10.1016/j.hrthm.2019.04.033
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1570-1574Informations de copyright
Copyright © 2019 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.