Pairs of ventricular premature beats, present in 10.0% of patients, were significantly related to an impaired prognosis for nonfatal AMI or cardiac death during a median 14-month follow-up.
Cohort (n=198)
Does the presence of ventricular premature beats on Holter monitoring predict cardiac events and correlate with myocardial scar or ischemia in patients admitted with chest pain but unconfirmed AMI?
In patients admitted with chest pain but unconfirmed AMI, pairs of ventricular premature beats on Holter monitoring identify those at higher risk for subsequent cardiac events and indicate the presence of chronic ischemic heart disease.
Ambulatory 24-h Holter monitoring was carried out in 198 patients who had been admitted because of suspected acute myocardial infarction (AMI) due to chest pain, but in whom AMI was not confirmed. During a follow-up period of 12-24 months (median 14 months) 16 cardiac events (i.e., nonfatal AMI or cardiac death) occurred. Ventricular premature beats (VPBs) were found in 65.2% of the patients, complex VPBs in 28.8%. Pairs of VPBs which were seen in 10.0% of the patients were the only important type of VPBs significantly related to an impaired prognosis. Thallium-201 scintigraphy was performed in 144 of the patients. VPBs were significantly related to scar formation (i.e., to permanent defects, but not to ischemia, specifically, to transient defects). It is concluded that ventricular arrhythmias in this patient category indicate presence of chronic ischemic heart disease, and that pairs of VPBs seem to identify patients at risk for cardiac events.
Madsen et al. (Sun,) conducted a cohort in Suspected acute myocardial infarction without confirmation (n=198). Ambulatory 24-h Holter monitoring was evaluated on Cardiac events (nonfatal AMI or cardiac death). Pairs of ventricular premature beats, present in 10.0% of patients, were significantly related to an impaired prognosis for nonfatal AMI or cardiac death during a median 14-month follow-up.