Interrelationship of variable coupling,multiformity and repetitive forms: Implications for classification of ventricular arrhythmias

Increased variability of the coupling interval of premature ventricular beats may help to identify high-risk patients with coronary artery disease

“…In addition, the R-on-T VPBs initiated malignant ventricular arrhythmias only in a small proportion of patients with this phenomenon [13]. Later study of Lowery et al [14] gave support for the relationship between variable coupling and occurrence of repetitive forms of VPBs. Cited authors showed that variable coupling greater than 80 ms had an 81% sensitivity and a 63% specificity for predicting association of repetitive forms.…”

“…Moreover, a negative predictive value was even more sticking. However, they did not solve whether the presence of an increased variation of coupling interval brings any prognostic information [14].…”

Preliminary Study of Coupling Intervals of Premature Ventricular Complexes in Dogs With Different Cardiac Diseases

“…Historically, cardiologists used 'form and frequency' of PVCs in predicting epidemiological risk and formulating therapeutic strategies. Throwing doubt at the signi cance of R-on-T phenomenon, Thanavaro et al (1983) and Lowery et al (1990) examined the association of coupling interval, PVC morphology and repetitive forms. The former examined 10 hour ECG recordings from patients, at least 2-weeks after a con rmed acute myocardial ischemic event (Thanavaro et al 1983).…”

“…Lowery's study (1990) investigated CI variability (CIV), the measure of the difference between maximum and minimum R-R interval of sequential PVCs, also referred to in other texts as ΔCI, and its association with different QRS morphologies. In addition, whether or not repetitive forms developed and the number of complexes of each repetitive event were also examined (Lowery et al 1990). The decision making tree of interpreting PVC morphology and CIV, found that patients with xed CI, lacked both repetitive forms, and multiformity, unlike patients with variable CI had multiformity and tended to have repetitive forms more frequently.…”

Increased Coupling Interval Variability – Mechanistic, Diagnostic and Prognostic Implication of Premature Ventricular Contractions and Underlying Heart Diseases –

“…On the other hand, Lowery et al indicated that a variable CI leads to multiform and repetitive PVC. 5 In this century, advances in ambulatory data analysis have clarified the CI dynamics as they relate to the following ventricular arrhythmia mechanism and underlying heart disease severity. However, the relationship between CI variability and fatal ventricular arrhythmia occurrence and prognosis are complicated (ie, Sosnowski et al 6 demonstrated high CI variability, whereas Lerma et al 7 concluded low CI variability as a new risk factor of fatal ventricular arrhythmias).…”