Key result
Frequent premature ventricular contractions (>10% burden) were significantly associated with a prolonged Tp-e interval (75 vs 62 ms, p<0.001) and increased Tp-e/QT ratio compared to seldom PVCs.
Why the study?
ECG parameters including Tp-e interval, Tp-e / QT ratio, fQRS, and HRV relate to cardiovascular morbidity and mortality, prompting investigation into their relation with PVC burden on 24-h ECG.
Does frequent premature ventricular contraction burden (>10%) correlate with altered myocardial repolarization markers and fragmented QRS in patients with palpitations?
Observational (n=199)
No
Does frequent premature ventricular contraction burden (>10%) correlate with altered myocardial repolarization markers and fragmented QRS in patients with palpitations?
Absolute Event Rate: 75% vs 62%
p-value: p=<0.001
Frequent premature ventricular contractions (>10% burden) are associated with impaired myocardial repolarization markers (prolonged Tp-e interval, increased Tp-e/QT ratio) and fragmented QRS, suggesting a higher risk profile for malignant arrhythmias.
May flag higher arrhythmic risk in frequent PVCs; hypothesis-generating for repolarization-based stratification pending prospective data.
Background/aim: Some electrocardiography (ECG) parameters such as Tp-e interval, Tp-e / QT ratio, fragmented QRS (fQRS), and heart rate variability (HRV) are related to cardiovascular mortality and morbidity. We aim to investigate the relation between premature ventricular contraction burden and these parameters on 24-h ECG recording. Materials and methods: The study is a retrospective investigation of the 24-h Holter ECG and echocardiography of 199 patients who underwent the procedures due to complaints of palpitation. A frequency of < 10% PVCs / 24 h was classified as seldom group (98 patients), while > 10% PVCs / 24 h was designated as frequent group (101 patients). Results: Tp-e interval was significantly longer (62 [54–78] vs 75 [60–84], p < 0.001), Tp-e / QT ratio was significantly increased (0.18 [0.16–0.20] vs 0.21 [0.18–0.22], p = 0.001) in frequent PVC group. The percentage of fQRS was significantly increased in frequent PVC group (30.6% vs 47.5%, p = 0.015). When the groups were compared, no significant difference was found in HRV time domain indices. Positive correlations were observed between PVC burden and Tp-e (r = 0.304, p < 0.001), Tp-e / QT (r = 0.275, p < 0.001). Conclusion: Our study showed that Tp-e interval, Tp-e / QT and fQRS are associated with frequency of PVCs. These measurements in patients with PVCs may form part of assessment of cardiovascular risk.
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Akdi et al. (2021) conducted an observational in Premature ventricular contractions (n=199). Frequent premature ventricular contractions (>10% burden) vs. Seldom premature ventricular contractions (<10% burden) was evaluated on Tp-e interval (ms) (p=<0.001). Frequent premature ventricular contractions (>10% burden) were significantly associated with a prolonged Tp-e interval (75 vs 62 ms, p<0.001) and increased Tp-e/QT ratio compared to seldom PVCs.
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