Rest premature ventricular contractions on routine ECG and prognosis in heart failure patients
- PMID: 20146783
- PMCID: PMC6932718
- DOI: 10.1111/j.1542-474X.2009.00340.x
Rest premature ventricular contractions on routine ECG and prognosis in heart failure patients
Abstract
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.
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References
-
- Engel G, Beckerman JG, Froelicher VF, et al Electrocardiographic arrhythmia risk testing. Curr Probl Cardiol 2004;29:365–432. - PubMed
-
- Dewey FE, Kapoor JR, Williams RS, et al Ventricular arrhythmias during clinical treadmill testing and prognosis. Arch Intern Med 2008;168:225–234. - PubMed
-
- Myers J, Buchanan N, Walsh D, et al Comparison of the ramp versus standard exercise protocols. J Am Coll Cardiol 1991;17:1334–1342. - PubMed
-
- Myers J, Do D, Herbert W, et al A nomogram to predict exercise capacity from a specific activity questionnaire and clinical data. Am J Cardiol 1994;73:591–596. - PubMed
-
- American College of Sports Medicine . Guidelines for Exercise Testing and Prescription. Philadelphia , PA , Lippincott, Williams, and Wilkins, 2000.
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