The relationship between premature ventricular complexes and index of cardiac-electrophysiological balance

Abstract

OBJECTIVE: Premature ventricular complexes are common in healthy individuals' ambulatory monitoring. The index of cardiac-electrophysiological balance may predict malignant ventricular arrhythmias. This study investigated the relation between Premature ventricular complex burden and index of cardiac-electrophysiological balance in 24-h Holter monitoring. METHODS: A total of 257 patients who were admitted to a cardiology outpatient clinic without structural heart disease and underwent 24-h Holter monitoring were included in the study. Demographic features, laboratory parameters, and electrocardiographic and echocardiographic values of all patients were obtained from the hospital database. Patients were categorized into the following four groups according to their premature ventricular complex burden: ≤5% premature ventricular complexes as group 1, >6 and ≤10% premature ventricular complexes as group 2, >11 and ≤20% premature ventricular complexes as group 3, and >20% premature ventricular complexes as group 4. QRS, QT, and T peak to end interval were measured by resting electrocardiography. QT interval was corrected using Bazett's formula. T peak to end interval/QT, T peak to end interval/corrected QT interval, index of cardiac-electrophysiological balance, and corrected index of cardio-electrophysiological balance ratios were calculated. RESULTS: There was no significant difference between groups regarding cardiovascular risk factors. In group 4, beta-blocker usage was significantly higher, and the serum magnesium levels were significantly lower than in other groups. There was no difference in QT duration or index of cardiacelectrophysiological balance values; however, corrected index of cardio-electrophysiological balance was significantly lower in the highest premature ventricular complex group (5.1, 5.1, 4.8, 4.7, p=0.005). In multivariate backward logistic regression analyses, it was found that lower corrected index of cardio-electrophysiological balance, lower serum magnesium levels, lower serum creatinine levels, larger left atrium size, and higher T peak to end interval were associated with higher premature ventricular complexes. CONCLUSION: Corrected index of cardio-electrophysiological balance is a novel and noninvasive marker that can predict premature ventricular complex burden in patients with structurally normal hearts.

The Relationship Between Premature Ventricular Complexes Burden and Cardiac-Electrophysiologic Balance Index After Premature Ventricular Complex Catheter Ablation

“…Recently, iCEB has been found to be a better predictor of arrhythmia risk compared to the Tp-e interval, QTc interval, and Tp-e/QTc ratio (16). In a study by Adali et al, iCEBc was found to be a marker that can predict PVCs in patients without structural heart disease (5). Our study found that iCEBc can predict PVC burden following PVC catheter ablation.…”

“…They can also present with symptoms such as presyncope, dyspnea, and fatigue and are often detected incidentally on an ECG (3,4). A PVC burden of more than 10% on 24-hour ambulatory rhythm monitoring increases the risk of heart failure (5). Ablation of frequent PVCs improves left ventricular ejection fraction (LVEF) in patients with left ventricular (LV) systolic dysfunction (6).…”

Therapy Efficacy of Idiopathic Ventricular Extrasystoles: A Real Life Study

“…In our study, 15 patients (23.8%) were treated unsuccessfully with fecainide and three (4.8%) with amiodarone at some point. Patients using diuretics can sometimes beneft from potassium or magnesium supplements [13].…”

Prognostic Value of Tpeak–Tend Interval in Early Diagnosis of Duchenne Muscular Dystrophy Cardiomyopathy

“…In patients with LV systolic dysfunction and an implanted ICD, Tpe independently predicted ventricular tachyarrhythmia, appropriate ICD therapy, and overall mortality [34,35]. In recent studies, Tp-e interval prolongation was associated with higher PVC burden in patients with structurally normal hearts, and the Tp-e interval has been shown to be helpful in predicting sustained idiopathic VT in patients with idiopathic PVC [36,37]. Since one of the re-entry requirements is the local distribution of myocardial repolarization, it is reasonable to expect that an increase in the total ventricular distribution of repolarization (DVR) may predispose patients to ventricular tachyarrhythmias and cardiac arrest.…”