Association of Electrocardiographic Morphology of Exercise-Induced Ventricular Arrhythmia with Mortality

Abstract

Right bundle-branch block- or multiple-morphology EIVA is associated with increased mortality. Inclusion of patients with isolated LBBB-morphology EIVA, which often is idiopathic, may contribute to differences in the prognostic importance of EIVA in previous studies.

Electrocardiographic patterns of exercise-induced ventricular arrhythmias in patients with and without coronary artery disease

“…This finding is compatible with previous studies suggesting that the RBBBconfiguration arrhythmia, presumably originating from the left ventricle, is often associated with left ventricular disease, depressed ventricular function and greater mortality compared to LBBB pattern [10].…”

“…Some morphologic characteristics of EIVAs have been shown to provide prognostic information [10]. In current study, we aimed to evaluate whether there is a relationship between the some EIVA morphologic patterns and the presence of CAD.…”

“…Although exercise represents a well-known triggering factor of ventricular arrhythmias in patients with CAD, mainly because of the increase in sympathetic activity and release of catecholamines, it is unclear if the prognosis associated with EIVAs differ based on the presence of CAD, ischemic changes during exercise, and/or the presence of premature ventricular contractions (PVCs) at rest (i.e., an indicator of the arrhythmic substrate) [1,10]. Some morphologic characteristics of EIVAs have been shown to provide prognostic information [10].…”

The prognostic value of exercise testing: Exercise capacity, hemodynamic response, and cardio-metabolic risk factors

“…Ventricular ectopy during exercise and recovery may also be a predictor of death, and the morphology of exercise-induced ventricular arrhythmia is debated for its prognostic importance. 12,13 Overall, studies have shown that there is a graded continuum of risk and additive prognostic effect with the increase in the number and different combinations of abnormal exercise testing parameters and heart-rate-related measures. [14][15][16] In this issue of the European Journal of Preventive Cardiology, Chrysohoou et al aim to investigate the differential association of exercise testing related parameters with cardio-metabolic risk factors including diabetes, obesity, hypertension, as well as smoking.…”

Is an Exercise Tolerance Test Indicated Before Beginning Regular Exercise? A Decision Analysis

“…Exercise tolerance test (ETT) with ECG treadmill testing would be a non-invasive, low-cost, and convenient tool for identifying people with a high probability of CAD and at risk of sudden cardiac death as suggested in some studies. [5][6][7] However, because of its limited sensitivity and specificity, ETT might be a poor universal screening tool for people with low probability of CAD and could generate many false positives. 8 The American College of Cardiology recommends that an ETT be considered for diabetics, men older than 45 years, and women older than 55 years who plan to start vigorous exercise, especially if they have been sedentary.…”