Risk factor algorithm used to predict frequent premature ventricular contraction-induced cardiomyopathy

Int J Cardiol. 2017 Apr 15:233:37-42. doi: 10.1016/j.ijcard.2017.02.007. Epub 2017 Feb 3.

Abstract

Background: Premature ventricular contraction (PVC) QRS duration (QRSd) and high PVCs burden are known as a risk factor of PVC-induced cardiomyopathy (CMP). The aim of this study is to find useful algorithm to predict PVC-induced CMP.

Methods: 180 patients (99 males, 51±14years) with frequent PVCs (>10%/24h), who underwent successful PVC ablation, were studied. Typical PVC-related symptoms were defined as the presence of palpitations or dropped beats during PVC. Group A (n=144) was symptomatic and Group B (n=36) was asymptomatic.

Results: The incidence of CMP was significantly higher in group B (group A=19%, group B=66%, p<0.001). In group A, there were significant differences, between the patients with normal EF and CMP, in terms of sex (p=0.005), daily PVC burden (p=0.012), distribution of PVCs with a LV site (p<0.009), and PVC QRSd (p<0.001). In group B, the PVC QRSd was significantly wider in patients with CMP. Multivariate analysis showed that PVC QRSd (p<0.001), PVC burden (p=0.022), and LV site (p=0.043) were risk factors for CMP.

Conclusions: Using our scoring algorithm for this patient sample, we are able to predict the development of PVC-induced CMP with 80% sensitivity, 81% specificity, 64% positive predictive value, and 91% negative predictive value.

Keywords: Cardiomyopathy; Electrocardiogram; Premature ventricular contraction; Symptom.

MeSH terms

  • Algorithms*
  • Cardiomyopathies / diagnosis
  • Cardiomyopathies / etiology*
  • Cardiomyopathies / physiopathology
  • Electrocardiography, Ambulatory
  • Female
  • Follow-Up Studies
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Republic of Korea / epidemiology
  • Retrospective Studies
  • Risk Assessment / methods*
  • Risk Factors
  • Stroke Volume
  • Ventricular Function, Left
  • Ventricular Premature Complexes / complications*
  • Ventricular Premature Complexes / epidemiology
  • Ventricular Premature Complexes / physiopathology