Prevalence of frequent premature ventricular contractions and nonsustained ventricular tachycardia in older women screened for atrial fibrillation in the Women's Health Initiative

Sofia E Gomez; Joseph Larson; Mark A Hlatky; Fatima Rodriguez; Matthew Wheeler; Philip Greenland; Michael LaMonte; Victor Froelicher; Marcia L Stefanick; Robert Wallace; Charles Kooperberg; Lesley F Tinker; Jenny Schoenberg; Elsayed Z Soliman; Mara Z Vitolins; Nazmus Saquib; Tomas Nuño; Bernhard Haring; Marco V Perez

doi:10.1016/j.hrthm.2024.02.040

Prevalence of frequent premature ventricular contractions and nonsustained ventricular tachycardia in older women screened for atrial fibrillation in the Women's Health Initiative

Heart Rhythm. 2024 Feb 23:S1547-5271(24)00212-1. doi: 10.1016/j.hrthm.2024.02.040. Online ahead of print.

Authors

Sofia E Gomez¹, Joseph Larson², Mark A Hlatky³, Fatima Rodriguez³, Matthew Wheeler³, Philip Greenland⁴, Michael LaMonte⁵, Victor Froelicher³, Marcia L Stefanick³, Robert Wallace⁶, Charles Kooperberg², Lesley F Tinker², Jenny Schoenberg², Elsayed Z Soliman⁷, Mara Z Vitolins⁷, Nazmus Saquib⁸, Tomas Nuño⁹, Bernhard Haring¹⁰, Marco V Perez³

Affiliations

¹ Department of Medicine, Stanford University School of Medicine, Stanford, California. Electronic address: segomez@stanford.edu.
² Fred Hutchinson Cancer Center, Seattle, Washington.
³ Department of Medicine, Stanford University School of Medicine, Stanford, California.
⁴ Department of Preventive Medicine, Feinberg School of Medicine at Northwestern University, Chicago, Illinois.
⁵ Department of Epidemiology and Environmental Health, University at Buffalo, Buffalo, New York.
⁶ Department of Epidemiology, University of Iowa College of Public Health, Iowa City, Iowa.
⁷ Department of Epidemiology and Prevention, Wake Forest University School of Medicine, Winston-Salem, North Carolina.
⁸ Department of Epidemiology, Sulaiman Alrajhi University, Al Bukayriyah, Saudi Arabia.
⁹ Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona.
¹⁰ Department of Internal Medicine, University of Würzburg, Würzburg, Germany.

PMID: 38403238
DOI: 10.1016/j.hrthm.2024.02.040

Abstract

Background: Frequent premature ventricular contractions (PVCs) and nonsustained ventricular tachycardia (NSVT) have been associated with cardiovascular disease and mortality. Their prevalence, especially in ambulatory populations, is understudied and limited by few female participants and the use of short-duration (24- to 48-hour) monitoring.

Objective: The objective of this study was to report the prevalence of frequent PVCs and NSVT in a community-based population of women likely to undergo electrocardiogram (ECG) screening by sequential patch monitoring.

Methods: Participants from the Women's Health Initiative Strong and Healthy (WHISH) trial with no history of atrial fibrillation (AF) but 5-year predicted risk of incident AF ≥5% by CHARGE-AF score were randomly selected to undergo screening with 7-day ECG patch monitors at baseline, 6 months, and 12 months. Recordings were reviewed for PVCs and NSVT (>5 beats); data were analyzed with multivariate regression models.

Results: There were 1067 participants who underwent ECG screening at baseline, 866 at 6 months, and 777 at 12 months. Frequent PVCs were found on at least 1 patch from 4.3% of participants, and 1 or more episodes of NSVT were found in 12 (1.1%) women. PVC frequency directly correlated with CHARGE-AF score and NSVT on any patch. Detection of frequent PVCs increased with sequential monitoring.

Conclusion: In postmenopausal women at high risk for AF, frequent PVCs were relatively common (4.3%) and correlated with higher CHARGE-AF score. As strategies for AF screening continue to evolve, particularly in those individuals at high risk of AF, the prevalence of incidental ventricular arrhythmias is an important benchmark to guide clinical decision-making.

Keywords: Atrial fibrillation; Cardiac monitoring; Frequent premature ventricular contractions; Nonsustained ventricular tachycardia; Remote monitoring; Ventricular arrhythmia.