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Observational Study
. 2013 Mar;2(1):61-7.
doi: 10.1177/2048872613476101.

Relationship between premature ventricular complexes and depressive symptoms in non-ST-elevation acute coronary syndrome

William Whang  1 , James Peacock, Ana V Soto, Tomas Borda, Anupama B Bhatt, Safiya I Richardson, Matthew Burg, Karina W Davidson
Affiliations
Observational Study

Relationship between premature ventricular complexes and depressive symptoms in non-ST-elevation acute coronary syndrome

William Whang et al. Eur Heart J Acute Cardiovasc Care. 2013 Mar.

Abstract

Aims: Depression is a recognized risk marker for mortality among acute coronary syndrome (ACS) patients. We hypothesized that ventricular arrhythmia detected by inpatient telemetry monitoring is more frequent among ACS patients with elevated depressive symptoms compared to those without depressive symptoms.

Methods and results: We analysed data from patients enrolled in a prospective observational study of depression in ACS. Telemetry recordings during the index admission (average recording 21.3±3.0 hours) were analysed for frequent premature ventricular complexes (PVCs), defined as ≥10 per hour. The self-report Beck Depression Inventory (BDI) was used to assess depressive symptoms. Among 200 ACS patients, frequent PVCs were observed in 29% of patients with moderate depressive symptoms (BDI ≥10), 27% of those with mild symptoms (BDI 5-9), and only 11% of those with no/minimal symptoms (p=0.02). Log-transformed PVCs per hour were associated with depressive symptom category (p=0.008). In a multivariable logistic regression model that included age, gender, left ventricular ejection fraction, cardiovascular risk score, heart rate, and QT interval, mild symptoms (OR 3.02, 95% 0.97-9.43, p=0.058) and moderate-severe symptoms (OR 3.94, 95% CI 1.27-12.22, p=0.018) were associated with frequent PVCs.

Conclusions: In this sample of ACS patients, depressive symptoms were independently associated with frequent PVCs during inpatient telemetry monitoring.

Keywords: Acute coronary syndrome; arrhythmia; depression.

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Figures

Figure 1.
Figure 1.
Example of cardiac telemetry report with median heart rate and premature ventricular complex counts per hour.
Figure 2.
Figure 2.
Sample of ECG tracing from cardiac telemetry report. N, normal QRS complex detected by the automatic algorithm; V, premature ventricular complex.
Figure 3.
Figure 3.
Mean natural log-transformed premature ventricular complexes (PVC) per hour in 200 ACS patients by depressive symptom score. Error bars indicate 95% confidence intervals. BDI, Beck Depression Inventory.
See this image and copyright information in PMC

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