Key result
VPC frequency, pattern, and underlying disease dictate sudden cardiac death risk, guiding asymptomatic ectopy treatment.
Why the study?
Which ventricular premature contractions should be treated to relieve symptoms and prevent sudden cardiac death?
Which ventricular premature contractions should be treated to relieve symptoms and prevent sudden cardiac death?
Frequent, complex VPCs in the setting of underlying heart disease (especially post-MI with LV failure) carry a serious risk of sudden cardiac death and warrant consideration for treatment.
Supports VPC frequency/pattern for sudden death risk stratification post-MI; leaves open whether suppressing asymptomatic ectopy improves outcomes.
• The treatment of ventricular premature contractions (VPCs) is based on two factors: bothersome symptoms from which the patient desires relief and the association of ectopic ventricular beats with sudden cardiac death. The sudden death risk related to ventricular ectopic beats is real, but appears to be a function of the frequency or pattern in which they occur plus the presence of underlying heart disease. A serious risk exists when frequent, multifocal, successive, or R-on-T-type VPCs occur in a patient monitored late after a fresh myocardial infarction, particularly if left ventricular failure is also present. Current data have been used to formulate levels of risk for sudden cardiac death on the basis of ventricular ectopic beats, which in turn provides a reasonable basis for the treatment of asymptomatic ventricular ectopy. (Arch Intern Med140:1423-1426, 1980)
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Richard B. Whiting (1980) conducted a review in Ventricular premature contractions. Treatment of ventricular premature contractions was evaluated on Sudden cardiac death. The risk of sudden cardiac death from ventricular premature contractions depends on their frequency, pattern, and underlying heart disease, providing a basis for treating asymptomatic ectopy.
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