Autonomic influences related to frequent ventricular premature beats in patients without structural heart disease

Frigy, Attila; Csiki, Endre; Caraşca, Cosmin; Szabó, István Adorján; Moga, Victor-Dan

doi:10.1097/md.0000000000011489

Cited by 17 publications

(17 citation statements)

References 11 publications

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“…The HRV is determined by autonomic nervous system activity. The propensity for lethal arrhythmias associated with either increased sympathetic or reduced vagal activity, reflected as decreased HRV, have been extensively studied in people (Bikkina et al 1998, Obias-Manno & Wijetunga 2004, Frigy et al 2018. From our data, some HRV variables, such as SDNN and SDNNidx, in symptomatic Boxer dogs were higher than in the asymptomatic group.…”

Section: Discussionmentioning

confidence: 62%

Prognostic value of coupling interval, prematurity index and heart rate variability in Boxer dogs

et al. 2019

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Boxer dogs with arrhythmogenic right ventricular cardiomyopathy (ARVC) can experience sudden cardiac death regardless of presence/absence of clinical signs. The aims of this retrospective study were two-fold: 1) to investigate the coupling interval (CI) and prematurity index (PI) of ventricular arrhythmias (VA), and the heart rate variability (HRV) in Boxers, and 2) to evaluate their impact on overall survival time. The first 24-hour Holter 36 client-owned Boxer dogs meeting inclusion/exclusion criteria were evaluated for the number, morphology, site of origin, complexity, CI and PI, of ventricular premature complexes (VPCs), and time domain HRV. The effect on survival was assessed, considering the presence/absence of ventricular tachycardia (VT), and syncope. All-cause mortality was considered as the end-point, with median survival times being obtained by Kaplan-Meier analyses and compared by log-rank test. Polymorphic VPCs were more common in symptomatic dogs than asymptomatic. VPCs in dogs with VT were less premature, due to the influence of heart rate on PI despite comparable CI. The PI and mean heart rate (HRme) were significantly different between VT and non-VT dogs but did not discriminate adequately between groups as standalone tests. Median survival time was shorter in Boxer dogs with VT (463 vs 1645 days, HR: 4.31, P=0.03). The HRV parameters, SDNN and SDANN, were both associated with prognosis. The CI and PI were not demonstrated to be prognostic surrogates in Boxer dogs with VA. HRme≥112bpm is 100% sensitive but only 46% specific for detecting VT in Boxers on the 24-hour Holter. Presence of VT, SDNN≤245ms, or SDANN≤134ms at the time of the first 24-hour Holter was associated with a shorter survival.

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Section: Discussionmentioning

confidence: 62%

Prognostic value of coupling interval, prematurity index and heart rate variability in Boxer dogs

et al. 2019

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“…Hourly PVC density was positively associated with sympathetic indices in fast ratedependent PVC [7] and positively associated with vagal indices in slow rate-dependent PVC in these studies [7,13]. Sympathetic nervous system activity, which was measured by the low frequency power/high frequency power ratio, was dominant in some PVCs [14], while vagally mediated parameters are enhanced in other PVCs [13]. Even though we did not include heart rate Fig.…”

Section: Discussionmentioning

confidence: 70%

Significant reduction in the density of premature ventricular complex with ß-blocker medication in fast rate-dependent premature ventricular complex

et al. 2020

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Background There is little data regarding types of idiopathic premature ventricular complex (PVC) according to heart rate dependence. Methods One hundred and sixty-eight patients with idiopathic PVC were enrolled in this study. Evaluation of the number of PVCs and total ventricular beats, and the density of PVC was done using 24 h Holter monitoring. Patients were divided into groups as having: fast rate-dependent (Group I), slow rate-dependent (Group II), and heart rate-independent PVC (Group III) based on the relationship between the number of hourly PVC and hourly heart rate. After ß-blocker medication, 24 h Holter monitoring was repeated. Results Among the 168 subjects, 66 (39.3%) patients were in Group I, 18 (10.7%) in Group II, and 84 (50.0%) in Group III. There were no significant differences in the baseline number of PVCs and total ventricular beats, and the density of PVC among the three groups. The number of PVCs was significantly reduced in patients with Group I (14,030 ± 11,463 beats/day vs. 7401 ± 10,464 beats/day, p < 0.001), and total ventricular beat was significantly reduced in patients with Group I (109,223 ± 17,564 beats/day vs. 96,182 ± 15,594 beats/day, p < 0.001) and Group III (106,515 ± 13,468 beats/day vs. 97,995 ± 12,960 beats/day, p < 0.001) after ß-blocker medication. The density of PVC was significantly reduced only in patients of Group I (12.9 ± 10.3% vs. 7.4 ± 10.3%, p = 0.001) after ß-blocker medication. Conclusions The type of PVC according to the heart rate dependence should be considered when treating idiopathic PVC with ß-blockers.

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“…1,2 PVC is an early depolarization arising from the ventricles and is characterized by premature QRS complexes that appear wide (usually>120mseq) and are not preceded by a p wave in electrocardiogram. 3,4 The majority of patients are asymptomatic, but PVCs are a common cause of a variety of symptoms such as palpitation, feeling of pause in cardiac beats, dizziness and rarely ventricular tachycardia accompanied by shortness of breath, chest discomfort, hypotension or/and syncope. 3 PVC in individuals with no history of structural heart diseases is relatively common and has been thought to be a benign phenomenon for years.…”

Section: Introductionmentioning

confidence: 99%

“…3,4 The majority of patients are asymptomatic, but PVCs are a common cause of a variety of symptoms such as palpitation, feeling of pause in cardiac beats, dizziness and rarely ventricular tachycardia accompanied by shortness of breath, chest discomfort, hypotension or/and syncope. 3 PVC in individuals with no history of structural heart diseases is relatively common and has been thought to be a benign phenomenon for years. Meanwhile, recent literature have revealed that recurrent PVCs may be associated with the occurrence of myocardial infarction, developing ventricular fibrillation (VF), and mortality in healthy subjects.…”

Section: Introductionmentioning

confidence: 99%

“…Meanwhile, recent literature have revealed that recurrent PVCs may be associated with the occurrence of myocardial infarction, developing ventricular fibrillation (VF), and mortality in healthy subjects. 3,5 The amounts of PVC attacks of more than 10-25% of total heart beats in a day have been reported to be associated with decreased ventricular function, ventricular dilation, and increased risk of cardiomyopathy. 2,6 Related risk factors and etiology of PVC are not fully known in patients with normal heart structure.…”

Section: Introductionmentioning

confidence: 99%

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The Relationship Between Epicardial Fat Tissue Thickness and Risk of Frequent Premature Ventricular Contractions

et al. 2021

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Objectives: This study aimed to evaluate the relation between epicardial fat tissue (EFT) thickness and frequent premature ventricular contractions. Methodology: In this cross-sectional study, patients with no structural heart diseases diagnosed with PVCs on a 24 holter rhythm monitoring were included. EFT thickness was measured by 2-dimensional transthoracic echocardiography. PVCs of more than 10 per hour were considered as frequent PVCs. To investigate the effect of independent variables, univariate logistic regression was performed. Results: Of total 50 studied patients, 64% were females. The mean age of subjects was 46.8 ± 13.1 years. Twenty-five patients were experiencing frequent PVCs of >10 per hour. In univariate analysis, age (OR= 1.05, 95 % CI; 1.01-1.10, p=0.050), left ventricular end diastolic diameter (LVEDD) (OR= 1.14, 95 % CI; 1.01-1.28, p=0.036) and left atrial (LA) diameter (OR= 1.35, 95 % CI; 1.11-1.62, p=0.002) were significantly associated with developing frequent PVC. EFT thickness was positively correlated with age (r= 0.389, p= 0.005) and inter-ventricular septum thickness in diastole (IVSD) (r= 0.384, p= 0.006). No significant correlation between EFT and PVCs was found (p=0.669). Conclusion: Patients with frequent PVCs had significantly higher LVEDD and LA diameter. Although patients with higher EFT thickness were more likely to experience frequent PVCs, there was no statistically significant correlation between EFT thickness and frequent PVCs.

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Autonomic influences related to frequent ventricular premature beats in patients without structural heart disease

Cited by 17 publications

References 11 publications

Prognostic value of coupling interval, prematurity index and heart rate variability in Boxer dogs

Prognostic value of coupling interval, prematurity index and heart rate variability in Boxer dogs

Significant reduction in the density of premature ventricular complex with ß-blocker medication in fast rate-dependent premature ventricular complex

The Relationship Between Epicardial Fat Tissue Thickness and Risk of Frequent Premature Ventricular Contractions

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