Continuous ECG monitoring demonstrated significant interday variance in PVC counts in 76% of ARVD/C patients, yet 24-hour monitoring correctly classified 89.6% of periods by Task Force Criteria.
Observational (n=40)
No
Does continuous ECG monitoring reveal significant interday variability in PVC counts among patients with ARVD/C, and does this affect diagnostic classification?
Although ARVD/C patients exhibit significant day-to-day variability in PVC burden, standard 24-hour ECG monitoring is sufficient to correctly classify the vast majority of patients according to the 2010 Task Force Criteria.
INTRODUCTION: Arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C) is an inherited cardiomyopathy, characterized by right ventricular dysfunction and ventricular arrhythmias. Premature ventricular contractions (PVCs) are an important measure in determining disease severity and constitute a minor criterion in the 2010 Task Force Criteria for the diagnosis of ARVD/C. Little information is available regarding the variability in PVCs. METHODS AND RESULTS: Patients (n = 40) from the Johns Hopkins ARVD/C registry, meeting diagnostic criteria were included. Single lead continuous 12-lead electrocardiogram (ECG) monitors (Zio® Patches) were applied to monitor PVC counts. Detailed demographic, phenotypic, and structural information were obtained from registry data. ECG monitors were worn for a mean period of 159.3 hours (±39.3). Average 24-hour PVC count in this population was 1,090.5 (interquartile range = 1,711). One-way analysis of variance demonstrated statistically significant interday variance in mean hourly PVC counts in 76% of ARVD/C-positive subjects (28/37, 3 cases excluded due to insufficient data). Eleven individuals (27.5%) had maximum 24-hour PVC counts of >500 with a corresponding minimum 24-hour PVC count of <500. The average 24-hour PVC count for each patient was derived for each day recorded. The 24-hour PVC count placed 89.6% of counts (223/249) on the correct side of the 500-PVC count. CONCLUSION: Statistically significant variation between 24-hour PVC counts is present in the ARVD/C population. However, 24-hour ECG monitoring was sufficient to identify 89.6% of 24-hour periods to the correct grouping based on 2010 Task Force Criteria.
Camm et al. (Fri,) conducted a observational in Arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C) (n=40). Continuous ECG monitoring was evaluated on Interday variance in mean hourly PVC counts. Continuous ECG monitoring demonstrated significant interday variance in PVC counts in 76% of ARVD/C patients, yet 24-hour monitoring correctly classified 89.6% of periods by Task Force Criteria.
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