Document Detail


Rest premature ventricular contractions on routine ECG and prognosis in heart failure patients.
MedLine Citation:
PMID:  20146783     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Premature ventricular contractions (PVC) at rest are frequently seen in heart failure (HF) patients but conflicting data exist regarding their importance for cardiovascular (CV) mortality. This study aims to evaluate the prognostic value of rest PVCs on an electrocardiogram (ECG) in patients with a history of clinical HF. METHODS AND RESULTS: We considered 352 patients (64 + or - 11 years; 7 females) with a history of clinical HF undergoing treadmill testing for clinical reasons at the Veterans Affairs Palo Alto Health Care System (VAPAHCS) (1987-2007). Patients with rest PVCs were defined as having > or = 1 PVC on the ECG prior to testing (n = 29; 8%). During a median follow-up period of 6.2 years, there were 178 deaths of which 76 (42.6%) were due to CV causes. At baseline, compared to patients without rest PVCs, those with rest PVCs had a lower ejection fraction (EF) (30% vs 45%) and the prevalence of EF < or = 35% was higher (75% vs 41%). They were more likely to have smoked (76% vs 55%).The all-cause and CV mortality rates were significantly higher in the rest PVCs group (72% vs 49%, P = 0.01 and 45% vs 20%, P = 0.002; respectively). After adjusting for age, beta-blocker use, rest ECG findings, resting heart rate (HR), EF, maximal systolic blood pressure, peak HR, and exercise capacity, rest PVC was associated with a 5.5-fold increased risk of CV mortality (P = 0.004). Considering the presence of PVCs during exercise and/or recovery did not affect our results. CONCLUSION: The presence of PVC on an ECG is a powerful predictor of CV mortality even after adjusting for confounding factors.
Authors:
Vy-Van Le; Teferi Mitiku; David Hadley; Jonathan Myers; Victor F 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:  15     ISSN:  1542-474X     ISO Abbreviation:  Ann Noninvasive Electrocardiol     Publication Date:  2010 Jan 
Date Detail:
Created Date:  2010-02-11     Completed Date:  2010-05-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9607443     Medline TA:  Ann Noninvasive Electrocardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  56-62     Citation Subset:  IM    
Affiliation:
Division of Cardiovascular Medicine, Stanford University, School of Medicine, VA Palo Alto Health Care System, Cardiology 111C, 3801 Miranda Ave, Palo Alto, CA 94304, USA. vyvanle@gmail.com
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MeSH Terms
Descriptor/Qualifier:
Adrenergic beta-Antagonists / therapeutic use
Aged
Blood Pressure
California / epidemiology
Electrocardiography / methods*,  statistics & numerical data*
Exercise Test / methods,  statistics & numerical data
Exercise Tolerance
Female
Follow-Up Studies
Heart Failure / diagnosis,  drug therapy,  epidemiology*
Humans
Kaplan-Meiers Estimate
Male
Middle Aged
Prognosis
Rest*
Smoking / epidemiology
Ventricular Premature Complexes / epidemiology*
Veterans / statistics & numerical data
Chemical
Reg. No./Substance:
0/Adrenergic beta-Antagonists

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


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