Long-Term Follow-up of Asymptomatic Healthy Subjects with Frequent and Complex Ventricular Ectopy

Abstract

From 1973 to 1983 we followed 73 asymptomatic healthy subjects who were discovered to have frequent and complex ventricular ectopy. Ventricular ectopy in these subjects was measured by 24-hour ambulatory electrocardiography, which showed a mean frequency of 566 ventricular ectopic beats per hour (range, 78 to 1994), with multiform ventricular ectopic beats in 63 per cent, ventricular couplets in 60 per cent, and ventricular tachycardia in 26 per cent. Asymptomatic healthy status was confirmed by extensive noninvasive cardiologic examination, although cardiac catheterization of a subsample of subjects disclosed serious coronary artery disease in 19 per cent. Follow-up for 3.0 to 9.5 years (mean, 6.5) was accomplished in 70 subjects (96 per cent) and documented one sudden death and one death from cancer. Calculation of a standardized mortality ratio (Monson's U.S. data, 8th revision) for 448 person-years of follow-up indicated that 7.4 deaths were expected, whereas 2 occurred (standardized mortality ratio, 27; P less than 0.05). A comparison of survival of the study cohort with that of persons without coronary artery disease or with mild disease, patients with moderate disease, and men with unrecognized myocardial infarction showed a favorable prognosis for the study cohort over 10 years. We conclude that the long-term prognosis in asymptomatic healthy subjects with frequent and complex ventricular ectopy is similar to that of the healthy U.S. population and suggests no increased risk of death.

Changes in spontaneous variability of ventricular ectopic activity as a function of time in patients with chronic arrhythmias.

“…weeks, 4 weeks, and 1 year or longer. The percent reductions in total PVCs required to exceed the 95% confidence limits of spontaneous variability at these intervals were 55%, 85%, 86%, 93%, 96%, and 96%, respectively.…”

Ventricular ectopic beats in structurally normal heart: When to stop investigations

“…During a six year follow up only two men died (from non-cardiac cause) and at necropsy neither had evidence of ischaemic heart disease or other cardiovascular disease. A study conducted by Kennedy 13 in 1985, suggested that in the absence of structural heart disease, even frequent and complex ventricular ectopics are associated with a benign prognosis. Alessandro Biffi et al 14 assessed 355 competitive athletes with ventricular arrhythmias on a 24-h ambulatory (Holter) ECG that was obtained because of either palpitations, the presence of ≥3 premature ventricular depolarization on resting 12-lead ECG, or both.…”

Relationship Between Premature ventricular complexes and Neutrophil–Lymphocyte Ratio in asymptomatic healty young men

“…PVC pathogenesis has traditionally been considered idiopathic and in the absence of severe clinical symptoms or structural cardiac abnormalities, their presence benign (1,2). Recent prospective studies evaluating the prognostic significance of PVC for sudden and total cardiac death in apparently healthy adults directly challenge this view.…”