Asymptomatic ventricular premature depolarizations are not necessarily benign

Europace. 2016 Jun;18(6):881-7. doi: 10.1093/europace/euv112. Epub 2015 May 14.

Abstract

Aims: Most patients with idiopathic ventricular premature depolarizations (VPDs) complain of symptoms related to this arrhythmia, but some patients are asymptomatic even with a high VPD burden. Our understanding of the relationship between symptoms and cardiomyopathy related to this arrhythmia remains limited.

Methods and results: We evaluated 801 subjects (381 men; mean age, 55 ± 17 years) who visited our outpatient clinic. All subjects were diagnosed with frequent VPDs (1% or >1000 beats/day). The patients were divided into two groups according to the presence or absence of typical VPD symptoms (palpitations or skipped beats during VPDs): symptomatic patients (n = 455) and asymptomatic patients (n = 346). Clinical and electrocardiogram parameters were compared between these two groups. In the symptomatic group, palpitations were the most frequent symptom (91%). Daily VPD burden (P = 0.90) and electrocardiogram parameters (P>0.05) did not differ significantly between groups. The incidence of frequent VPDs with left ventricular dysfunction was significantly higher in the asymptomatic group (symptomatic patients, 3.0%; asymptomatic patients, 10.5%; P < 0.001).

Conclusion: The absence of typical VPD-related symptoms may be a risk factor for cardiomyopathy and be associated with an adverse outcome.

Keywords: Arrhythmia; Cardiomyopathy; Ventricular premature depolarization.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Cardiomyopathies / diagnostic imaging
  • Cardiomyopathies / epidemiology*
  • Death, Sudden, Cardiac / epidemiology*
  • Echocardiography
  • Electrocardiography, Ambulatory
  • Female
  • Humans
  • Male
  • Middle Aged
  • Republic of Korea
  • Retrospective Studies
  • Risk Factors
  • Stroke Volume
  • Ventricular Dysfunction, Left / diagnostic imaging*
  • Ventricular Premature Complexes / complications*
  • Ventricular Premature Complexes / diagnosis*