Electrocardiographic findings in 67,375 asymptomatic subjects

Hiss, Roland G.; Lamb, Lawrence E.; Allen, Margaret F.

doi:10.1016/0002-9149(60)90047-3

Cited by 165 publications

(55 citation statements)

References 13 publications

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“…Premature ventricular contractions (PVC) are very common arrhythmias in clinical practice [1][2][3] . They may occur in healthy individuals with no evidence of structural cardiopathy [2][3][4][5] and most originate in the right ventricular outflow tract (RVOT) [1][2][3] .…”

Section: Introductionmentioning

confidence: 99%

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Ablação com radiofreqüência de extra-sístoles da via de saída do ventrículo direito

Darrieux¹,

Scanavacca²,

Hachul³

et al. 2007

Arq. Bras. Cardiol.

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SummaryObjectives: To evaluate if radiofrequency catheter ablation is an effective procedure for the treatment of right ventricular outflow tract premature ventricular contraction (RVOT-PVC) and ascertain if it results in an improvement of symptoms.Methods: A prospective study with 30 consecutive patients (mean age 40 ± 13 years, 25 females), with no apparent structural cardiopathy, with very frequent (mean density of 1,263 ± 593/h) RVOT-PVC, symptomatic for more than one year (mean = 74 months) and resistant to antiarrhythmic drugs (3 ± 1.7, including beta-blockers), who underwent radiofrequency catheter ablation.Results: After the first procedure, there were 23 initial successful cases (76.6%) and 7 initial failures (23.4%). Four patients experienced relapses, two of whom did not undergo the second procedure. The second procedure was carried out in 9 patients (7 initial failures and 2 relapses), and there was success in 5 additional patients, one of them by epicardial access. The final success rate was 80% (24/30), and there were no major complications. After a mean follow-up of 14 ± 6 months, in the successful group there was a reduction greater than 90% in density of premature ventricular contractions (PVC) (24/24; p<0.0001) and a resulting absence of symptoms in the majority of patients (23/24; p<0.001).Conclusion: Radiofrequency catheter ablation is a safe and effective treatment for patients with persistent and symptomatic PVC with RVOT morphology.

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Section: Introductionmentioning

confidence: 99%

“…They may occur in healthy individuals with no evidence of structural cardiopathy [2][3][4][5] and most originate in the right ventricular outflow tract (RVOT) [1][2][3] .…”

Section: Introductionmentioning

confidence: 99%

Ablação com radiofreqüência de extra-sístoles da via de saída do ventrículo direito

Darrieux¹,

Scanavacca²,

Hachul³

et al. 2007

Arq. Bras. Cardiol.

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“…Brodsky and co-workers'2 found PVCs in 25 of 50 apparently normal male medical students, ages [23][24][25][26][27] years, in whom cardiac disease was excluded by noninvasive testing. Clarke and co-workers'3 found significant ventricular arrhythmias, including frequent ventricular ectopic beats, R-on-T phenomenon, multifocal ventricular ectopic beats, bigeminy and ventricular tachycardia in 10 of 86 subjects (12%) who were apparently healthy by history, physical examination, electrocardiography, and biochemical and hematological screening.…”

mentioning

confidence: 99%

Premature ventricular complexes in the absence of identifiable heart disease.

et al. 1981

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SUMMARY To define the prevalence, frequency and characteristics of premature ventricular complexes (PVCs) in adults free of recognizable heart disease, we performed 24-hour ambulatory electrocardiography on 101 subjects (51 men and 50 women, mean age 48.8 years) in whom physical examination, chest x-ray, ECG, echocardiogram, maximal exercise stress test, right-and left-heart catheterization and coronary arteriography were normal. Thirty-nine subjects had at least 1 PVC/24 hours, but only four had more than 100 PVCs/24 hours and fewer than five had more than five PVCs in any given hour. The probability of having at least 1 PVC/24 hours increased with age (chi square = 11.789, p = 0.019). The number of PVCs/24 hours was also positively associated with age (r -0.33, p = 0.001). There was no consistent relationship between the presence or number of PVCs/24 hours and sex, blood pressure, weight, height, body mass index, serum potassium or calcium, cholesterol and triglyceride, hemoglobin, the ingestion of coffee, tea or alcohol, and cigarette smoking. Four subjects had multiform PVCs, two of whom had early PVCs.

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“…The importance of IAB is based not only on its prevalence, that is, its truly pandemic proportions, but also on the markedly dysfunctional left atrium ("an atrial cardiomyopathy" 4 ) with IAB and the predictability of consequences such as atrial arrhythmias, particularly atrial fibrillation, reduction of left ventricular (LV) performance by diminished atriogenic preload, and potential systemic embolism. It is "poorly perceived" due to its continued poor recognition and understanding among otherwise excellent electrocardiographers who have published on the subject [5][6][7][8][9][10][11][12][13][14][15][16][17] (and many personally observed). The reasons include the following: (1) Despite Bayés DeLuna's meticulous attention to interatrial block 18 and the outstanding contributions of Greek investigators, 19 it receives scant attention; for example, in one authoritative textbook (which appears to eschew "encyclopedic" inclusiveness).…”

Section: Introductionmentioning

confidence: 99%

Interatrial block: Pandemic prevalence concealed by anachronistic electrocardiographic standards

2005

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SummaryBackground: Interatrial block (IAB; P waves ≥ 110 ms duration) has been reported in over 40% of unselected patients in sinus rhythm at widely separated general hospitals. It is thus of "pandemic" proportions. It should be better appreciated because it represents a large, baggy, poorly functional left atrium and is a forerunner of atrial fibrillation, atrial flutter, and other arrhythmias.Hypothesis: A search of all 12 leads will disclose the true prevalence of IAB in contrast to traditional reliance on lead II, as widely proposed in textbooks and other literature.Methods: In all, 500 consecutive unselected electrocardiograms (ECGs) were investigated using every lead and a magnifying graticule. For greater specificity, a minimal P duration of ≥ 120 ms was selected.Results: Thirty-one ECGs were discarded because of atrial arrhythmia, poor baseline, or undetectable P waves, leaving a base of 469 ECGs, the denominator for the results. A total of 182 patients had IAB, representing 38.8% of this series. The widest P wave was usually found in multiple leads (95.1% of patients). The widest P waves were found only in precordial leads in 59 patients and only in limb leads in 18 patients. "Traditional" lead II detected only 97 cases (53.3%), and IAB was found more frequently in leads V 3 and V4.Conclusions: Results confirm the pandemic frequency of IAB in one-third of hospitalized patients. Interpreters of ECGs should seek IAB in all 12 leads since reliance on lead II alone resulted in only 53.3% of the total cases. Its prevalence and serious implications with regard to patients' current and future status make this necessary.

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Electrocardiographic findings in 67,375 asymptomatic subjects

Cited by 165 publications

References 13 publications

Ablação com radiofreqüência de extra-sístoles da via de saída do ventrículo direito

Ablação com radiofreqüência de extra-sístoles da via de saída do ventrículo direito

Premature ventricular complexes in the absence of identifiable heart disease.

Interatrial block: Pandemic prevalence concealed by anachronistic electrocardiographic standards

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