Diagnostic and prognostic significance of premature ventricular complexes in community and hospital-based participants: A scoping review

Abstract

Background While there are published studies that have examined premature ventricular complexes (PVCs) among patients with and without cardiac disease, there has not been a comprehensive review of the literature examining the diagnostic and prognostic significance of PVCs. This could help guide both community and hospital-based research and clinical practice. Methods Scoping review frameworks by Arksey and O’Malley and the Joanna Briggs Institute (JBI) were used. A systematic search of the literature using four databases (CINAHL, Embase, PubMed, and Web of Science) was conducted. The review was prepared adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Review (PRISMA-ScR). Results A total of 71 relevant articles were identified, 66 (93%) were observational, and five (7%) were secondary analyses from randomized clinical trials. Three studies (4%) examined the diagnostic importance of PVC origin (left/right ventricle) and QRS morphology in the diagnosis of acute myocardial ischemia (MI). The majority of the studies examined prognostic outcomes including left ventricular dysfunction, heart failure, arrhythmias, ischemic heart diseases, and mortality by PVCs frequency, burden, and QRS morphology. Conclusions Very few studies have evaluated the diagnostic significance of PVCs and all are decades old. No hospital setting only studies were identified. Community-based longitudinal studies, which make up most of the literature, show that PVCs are associated with structural and coronary heart disease, lethal arrhythmias, atrial fibrillation, stroke, all-cause and cardiac mortality. However, a causal association between PVCs and these outcomes cannot be established due to the purely observational study designs employed.

Premature atrial and ventricular contractions detected on wearable-format electrocardiograms and prediction of cardiovascular events

“… 1 Our data complement these studies and provide strong evidence of a link between PACs in 15 s ECGs and incident AF. A recent systematic review on PVCs found four community-based studies reporting on standard 12-lead ECG, with some conflicting results, 3 , 10 , 25 , 27 and Nguyen et al 11 have recently shown that PVCs were associated with an increased risk of AF, HF, and mortality in CHS and ARIC cohorts.…”

Evaluation of premature ventricular complexes during in‐hospital ECG monitoring as a predictor of ventricular tachycardia in an intensive care unit cohort

“…Since the CAST study, which is dated, research on the significance of PVCs has shifted in large part to outpatient populations, with a focus on the role that frequent PVCs might have on cardiomyopathies and/or HF (Marcus, 2020; Suba et al, 2021). Our study is unique in that no prior study has reported on six different PVC types and their association with VT in ICU patients.…”

Association Between Left Ventricular Scar and Ventricular Ectopy in People Living With and Without HIV

“…Among community-dwelling populations of PWOH, VE has been reported as a surrogate marker of risk for adverse outcomes. 8 Studies show an association between increased frequency of PVCs and greater odds of a subsequent decrease in LVEF and incident HF independent of coronary heart disease. 7 , 29 Presence of PVCs also identifies a subset of otherwise low-risk individuals, including those without overt structural and functional LV abnormalities, as having higher risk for cardiovascular disease-related death including sudden cardiac death.…”