Publication Date
1-1-2022
Journal
The Texas Heart Institute Journal
DOI
10.14503/THIJ-20-7265
PMID
35226106
Publication Date(s)
January 2022
Language
English
PMCID
PMC8884278
PubMedCentral® Posted Date
2-28-2022
PubMedCentral® Full Text Version
Post-Print
Published Open-Access
yes
Keywords
Echocardiography, electrocardiography, electrocardiography, ambulatory, retrospective studies, sex distribution, ventricular dysfunction, left/epidemiology/physiopathology, ventricular premature complexes
Copyright
This work is licensed under a Creative Commons Attribution-NonCommercial-No Derivative Works 4.0 International License.
Abstract
Frequent ventricular premature complexes (VPCs) and VPC QRS duration are risk factors for left ventricular (LV) dysfunction. To determine which clinical characteristics and electrocardiographic features are associated with LV dysfunction (ejection fraction,
We identified 412 consecutive outpatients (mean age, 54.7 ± 16.8 yr; 227 women [55.1%]) who were diagnosed with frequent VPCs and had no structural heart disease from January 2010 through December 2017. Available transthoracic echocardiograms and 24-hour Holter monitoring data were evaluated to correlate the occurrence of VPCs and symptoms.
Typical VPC-related symptoms (palpitations or dropped beats) were observed in 251 patients (61.1%). Electrocardiograms revealed VPCs with a left bundle branch block–like morphology in 327 patients (79.5%) and VPCs with an inferior axis in 353 (85.8%). Twenty-six patients (6.3%) were diagnosed with VPC-related LV dysfunction. The mean VPC burden did not differ significantly by LV functional status (11.06% ± 10.13% [normal] vs 14.41% ± 13.30% [impaired]; P=0.211). Patients with impaired LV function were more often men (P=0.027), had no typical VPC-related symptoms (P=0.006), and had significantly longer VPC QRS durations (mean, 157 ms vs 139 ms; P <0.01).
Our findings suggest that male sex, absence of typical VPC-related symptoms, and a VPC QRS duration >157 ms are associated with LV dysfunction in patients with frequent VPCs, findings that may be useful in predicting such dysfunction.