Document Detail


Exercise-induced ventricular arrhythmias and cardiovascular death.
MedLine Citation:
PMID:  15649237     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Exercise-induced ventricular arrhythmias (EIVA) are frequently observed during exercise testing. However, the clinical guidelines do not specify their significance and so we examined this issue in our population. METHODS: A retrospective analysis of prospectively collected data was performed on 5754 consecutive male veterans referred for exercise testing at two university-affiliated Veterans Affairs Medical Centers. Exercise test responses were recorded and cardiovascular mortality was assessed after a mean follow-up of 6 +/- 4 years. EIVA were defined as frequent premature ventricular complexes (PVCs) constituting more than 10% of all ventricular depolarizations during any 30-second ECG recording, or a run of three or more consecutive PVCs during the exercise test or recovery. RESULTS: EIVA occurred in 426 patients (7.4%). There were 550 (10.6%) cardiovascular deaths during follow-up. Seventy two (17%) patients with EIVA died of cardiovascular causes, whereas 478 (9.0%) of patients without EIVA died of cardiovascular causes (P < 0.001). Patients with EIVA had a higher prevalence of cardiovascular disease, resting PVCs, resting ST depression, and ischemia during exercise than patients without EIVA. In a Cox hazards model adjusted for age, cardiovascular disease, exercise-induced ischemia, ECG abnormalities, exercise capacity and risk factors, EIVA was significantly associated with time to cardiovascular death. The combination of both resting PVCs and EIVA was associated with the highest hazard ratio. CONCLUSIONS: EIVA are independent predictors of cardiovascular mortality after adjusting for other clinical and exercise test variables; combination with resting PVCs carries the highest risk.
Authors:
James Beckerman; Anima Mathur; Stephen Stahr; Jonathan Myers; Sung Chun; Victor Froelicher
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc     Volume:  10     ISSN:  1082-720X     ISO Abbreviation:  Ann Noninvasive Electrocardiol     Publication Date:  2005 Jan 
Date Detail:
Created Date:  2005-01-14     Completed Date:  2005-05-03     Revised Date:  2008-03-10    
Medline Journal Info:
Nlm Unique ID:  9607443     Medline TA:  Ann Noninvasive Electrocardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  47-52     Citation Subset:  IM    
Affiliation:
Division of Cardiovascular Medicine, Stanford University Medical Center, Palo Alto, California, USA.
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MeSH Terms
Descriptor/Qualifier:
Analysis of Variance
California / epidemiology
Cardiovascular Diseases / mortality*,  physiopathology*
Chi-Square Distribution
Electrocardiography
Exercise Test*
Humans
Male
Middle Aged
Prognosis
Proportional Hazards Models
Registries
Retrospective Studies
Risk Factors
Survival Analysis
Ventricular Fibrillation / mortality*,  physiopathology*
Ventricular Premature Complexes / physiopathology
Veterans

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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