Abstract 14646: Quantity and Complexity of PVCs, Heart Rate and QRS duration Predict Abnormal Left Ventricular Function in Patients with Frequent PVCs Undergoing 24-Hour Ambulatory ECG Monitoring
Background: Frequent premature ventricular complexes (PVCs) have been associated with development of cardiomyopathy. Recent studies examining predictors of cardiomyopathy in pts with frequent PVCs have largely been limited by the study of highly selected pts referred for catheter ablation. We sought to determine the variables associated with cardiomyopathy in a general population of pts with frequent PVCs identified through 24 hour ambulatory ECG screening.
Methods: All 1006 pts (mean age 55 ± 18 years; 57% female) who had 12-Lead 24 Hour ECGs at our institution in 2008 were studied. Variables including frequency and type of ventricular ectopy, native complex QRS duration, and mean heart rate were extracted. A > 5% PVC burden (PVCs/total QRS complexes) was used to define frequent PVCs and a LVEF < 50% was considered abnormal.
Results: A total of 55 pts with frequent PVCs were identified from the study group, with a median number of PVCs of 11,914 (IQR 6,399 - 21,107). Among the 48 pts with LVEF measurements available at time of ECG monitoring (mean LVEF 54% ± 13%), 16 pts had abnormal LVEF. There were no differences in cardiac medication use, coronary artery disease, heart failure or renal function between pts with and without normal LVEF. Univariate linear correlates of LVEF and logistic predictors of abnormal LVEF are shown in the Table. In multivariate models, the quantity of PVC couplets (linear and logistic) and QRS duration (linear only) were independent predictors of abnormal LVEF. Regression models excluding significant multivariate predictors included alternate measures of PVC burden with similar overall predictive power.
Conclusions: In a cross-sectional analysis of pts with frequent PVCs, measures of quantity and complexity of ventricular ectopy, heart rate and PVC QRS duration predict the presence and severity of LV dysfunction. These findings may have important implications in the identification of patients with frequent PVCs at risk of cardiomyopathy.
- © 2012 by American Heart Association, Inc.