Characteristics associated with the symptoms of premature ventricular contractions: patterns beyond electrocardiogram

Abstract

Background: The management of idiopathic premature ventricular contractions (PVCs) is mainly based on the presence of PVC-related symptoms. However, the characteristics associated with the presence of PVC-related symptoms and why many patients of PVCs reported no symptom were still unclear. In this study, we tried to identify the characteristics associated with the presence of PVC-related symptoms. Methods: Patients of idiopathic PVCs with 24-h PVC burden more than 1% were enrolled and were assigned to symptomatic group if they reported palpitation or skipped heartbeat, or symptomless group if they denied any symptom. Demographic data, characteristics of PVCs on 12-lead electrocardiogram (ECG) and 24-h ECG were analyzed and compared between two groups. Origins of PVCs were recorded for part of patients who underwent radio-frequency ablation. Results: PVC burden was not statistically different between patients with and without symptoms. More symptomatic patients of PVCs were female and slim, had low ejection fraction of left ventricle, high proportions of daytime PVCs especially PVCs in the morning, with the presence of PVCs positively associated with heart rate, and had higher prevalence of paired PVCs, interpolated PVCs and non-sustained ventricular tachycardia. Conclusion: Female gender, low BMI, daytime PVCs, fast-heart rate-dependent PVCs, the presence of paired PVCs, interpolated PVCs and non-sustained ventricular tachycardia were associated with the presence of PVC-related symptoms.