Exercise-Induced Ventricular Ectopy and Cardiovascular Mortality in Asymptomatic Individuals

Samia MoraAssociate professor, Harvard Medical School, Brigham and Women's Hospital

“Currently, most clinicians tend to ignore PVCs that occur during stress testing, but here we showed that PVCs that occurred in recovery — in particular if they are two or more in a row, frequent, multifocal, or R-on-T — identified higher-risk asymptomatic individuals who may benefit from further intensifying preventive efforts. Importantly, the risk carried by these high-grade PVCs — approximately 80% higher CV mortality risk — was independent of standard risk factors or even other exercise testing variables, and mostly identified individuals who were more likely to die from CVD after 10 years of follow-up. This was in contrast to PVCs that occurred only during exercise, which were not associated with increased risk after accounting for other CV or exercise test variables.”

Marwan RefaatCardiologist, American University of Beirut

“For instance, during review of exercise stress tests for asymptomatic patients, health care providers could identify individuals at increased risk of cardiovascular mortality after noting high-grade PVCs during the recovery phase of exercise tests. This could prompt the clinician to schedule more frequent follow-up and to intensify efforts to reduce this risk.”