Extended 14-day ambulatory ECG monitoring nearly doubled the identification of patients reaching a 10% premature ventricular contraction burden threshold compared to 24 hours of monitoring.
Observational (n=101)
No
Does 14-day extended ambulatory ECG monitoring improve the identification of clinically significant PVC burden compared to 24-hour monitoring?
Extended 14-day ambulatory ECG monitoring captures significant day-to-day variability in PVC burden and substantially increases the detection of clinically significant ectopy compared to standard 24-hour monitoring.
BACKGROUND: Frequent premature ventricular contractions (PVCs) can cause a reversible reduction in systolic function. Most studies use 24-hour ambulatory electrocardiograms (AECGs) to assess PVC burden; however, PVC counts vary across 24-hour periods. We hypothesized that extended AECG monitoring would better identify clinically significant ectopy. METHODS: All 14-day AECGs performed at the San Francisco Veterans Affairs Medical Center between 2012 and 2015 (N = 694) were reviewed, and individuals with PVC counts ≥1.0% of total heartbeats were included (N = 101). Daily PVC counts and the range of these values across 24-hour periods were assessed. Median time for these ranges to cross clinically significant thresholds (PVCs ≥ 10%, 15%, or 20% of total heartbeats) was determined. RESULTS: Median PVC burden was 2.6% of total heartbeats (interquartile range IQR: 1.6-5.4%) and the median range across 24-hour periods was 3.6% (IQR: 2.0-9.1%). Individual ranges of daily PVC burden crossed thresholds of 10%, 15%, and 20% of total heartbeats in 26.7%, 16.8%, and 6.9% of patients, respectively. Median time to detecting an individual's maximum PVC burden was 6 days (IQR: 2-11 days). While 75% of those who reached the 20% threshold did so on day one of monitoring, only 53% of those reaching the 10% threshold did similarly, with a continually increasing yield throughout the 14-day monitoring period. CONCLUSIONS: PVC burden varies widely from day-to-day. While most patients with PVC burdens ≥20% were detected with 24 hours of monitoring, extended monitoring nearly doubled the identification of those reaching the 10% threshold.
Loring et al. (Wed,) conducted a observational in Premature ventricular contractions (PVCs) (n=101). Extended (14-day) ambulatory ECG monitoring vs. 24-hour ambulatory ECG monitoring was evaluated on Time to cross clinically significant PVC thresholds (≥10%, 15%, or 20% of total heartbeats). Extended 14-day ambulatory ECG monitoring nearly doubled the identification of patients reaching a 10% premature ventricular contraction burden threshold compared to 24 hours of monitoring.