Key Points
- To investigate how various clinical and electrocardiographic data relate to premature ventricular contractions (PVCs).
- Analyzed arrhythmias using 24-hour Holter monitoring in 244 patients with chest pain.
- Determined relationships between PVCs and indicators of myocardial fibrosis using categorical linear models.
- Conducted automated quantitative analysis of left ventricular contraction using right anterior oblique view of left ventriculogram.
- Myocardial fibrosis indicated by abnormal left ventricular contraction was the only independent predictor of frequent PVCs (P < 0.0001).
- Prevalence of greater than or equal to 2 PVCs/hour varied significantly by the number of abnormal segments: 11% (0), 44% (1-3), 73% (4-6), 100% (7-9) (P < 0.01).
- Similar quantitative relationship identified between PVCs and abnormal forces on electrocardiograms indicating myocardial infarction.
Structured PICO
PPopulation244 patients evaluated for chest pain by coronary angiography and left ventriculography
OOutcomeFrequent and complex ventricular arrhythmias (premature ventricular contractions) analyzed by 24-hour Holter monitorsurrogate
Myocardial fibrosis, as indicated by abnormal left ventricular contraction and QRS changes, is a strong independent predictor of frequent and complex ventricular arrhythmias in patients evaluated for chest pain.