Incidence and prognostic significance of ventricular arrhythmias in individuals without detectable heart disease

Bethge, Klaus-Peter; Bethge, D.; Meiners, G.; Lichtlen, Paul R.

doi:10.1093/oxfordjournals.eurheartj.a061471

Cited by 40 publications

(17 citation statements)

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“…Therefore, their clinical picture is different than the patients described above. Since ventricular arrhythmias are common in individuals without detectable disease (Bethge et al, 1983;Bjerregaard et al, 1982;Brodsky et al, 1977;Hinkle et al, 1974;Kennedy and Underhill, 1976), we thought that ventricular arrhythmias might be common in our patients with recent uncomplicated MI. Data in this subset of patients were unavailable, and we decided to assess the incidence of arrhythmias in patients with recent and uncomplicated MI, who were free of symptoms of cardiac arrhythmias, had a normal heart function, were free of unstable or variant angina pectoris, and were not taking drugs affecting myocardial vulnerability.…”

Section: Introductionmentioning

confidence: 78%

“…Twenty-four hour ambulatory electrocardiograph is considered to be sufficient, but increasing the hours of recording is more effective (Kennedy et al, 1978;Roberts et al, 1982). Simple ventricular arrhythmias are common in individuals without detectable heart disease and, at times, complex ventricular arrhythmias may be be observed (Bethge et al, 1983;Bjerregaard et al, 1982;Brodsky et al, 1977;Hinkle et al, 1974;Kennedy and Underhill, 1976). Several investigations have shown that in patients with recent myocardial infarction (MI) complex and frequent ventricular arrhythmias are common (Burkart, 1984;Coronary Drug Project Research Gmup, 1974;Manager Cats et al, 1979;Moss et al, 1979;Ruberman et al, 1977;Sculze et al, 1975;Stein and Jungmann, 1979; Thavanaro et a f .…”

Section: Introductionmentioning

confidence: 99%

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Incidence of complex ventricular arrhythmias in asymptomatic patients with recent myocardial infarction

Cocco

Strozzi

Pansini

et al. 1985

Clinical Cardiology

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Summary:The incidence of ventricular extrasystoles (VES) was documented in 50 patients with recent uncomplicated myocardial infarction, with a 72-h two-channel ambulatory electrocardiogram. All patients were free of symptoms of arrhythmias; unstable angina pectoris and heart failure were absent. A total of 82 % of the patients had VES: 23/50 patients had multiform or complex VES, 8/50 patients had ventricular tachycardia. VES were independent of heart rate and stable angina pectoris. Thus, frequent and complex VES are common in asymptomatic patients with uncomplicated recent myocardial infarction. Even in the absence of symptoms, ambulatory electrocardiography is useful. The prognostic significance of asymptomatic complex VES in these patients remains unsettled.

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Section: Introductionmentioning

confidence: 78%

Section: Introductionmentioning

confidence: 99%

Incidence of complex ventricular arrhythmias in asymptomatic patients with recent myocardial infarction

Cocco

Strozzi

Pansini

et al. 1985

Clinical Cardiology

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“…Most of the studies have found that, while the occurrence of VEA in asymptomatic, apparently healthy subjects is probably benign (Hinkle 1974;Bethge 1983;Kennedy 1985), its occurrence in individuals with symptomatic heart disease, particularly coronary artery disease, appears to be associated with an increased risk of sudden death (Hinkle 1974;Ruberman 1977;Moss 1977).…”

Section: General Epidemiolorv Of Veamentioning

confidence: 99%

“…A number of studies have followed such populations for several years and have found no increased incidence of heart disease (Bethge 1983, Kennedy 1985. Even complex VEA does not necessarily carry an increased risk of morbidity or mortality.…”

Section: General Epidemiolorv Of Veamentioning

confidence: 99%

A stochastic characterization of chronic ventricular ectopic activity

Albrecht

Cohen

Mark

1988

IEEE Trans. Biomed. Eng.

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Ventricular ectopic beats are clinically important because of their association with the problem of sudden cardiac death. Ventricular ectopic activity (VEA) is most commonly evaluated using long-term ambulatory electrocardiographic (ECG) recordings. The results of these recordings are usually summarized in the form of hourly counts of VEA events.Although such hourly counts are useful, they are a nonspecific measure which, in effect, treats VEA generation as an unpredictable process.This thesis develops a new means for characterizing the activity of the VEA-generating mechanism using the beat type and timing information of the long-term ECG. The approach is founded on the hypothesis that the VEA mechanism is often stable over time, although its activity may be modulated by physiologic influences and by the timing of the sino-atrial node impulses.This hypothesis implies that there should be some relationship between the beat type and timing of preceding beats and the subsequent generation of ectopic beats.The VEA generation was characterized by a multi-dimensional conditional distribution which gives the probability that an ectopic beat will follow a specific conditioning sequence of beat types and intervals. Using this approach a three part study was performed. The first step examined the conditional distributions and tested the null hypothesis that the generation of ectopic beats is unpredictable.Using a database of half-hour ECG tapes from 66 patients, the null hypothesis was rejected at p=0.005 in 80% of the tapes.The second step developed a means of displaying the multidimensional distributions. By an appropriate transformation of the conditioning variables, the distributions could be represented as one-dimensional distributions. The resulting distributions were useful for. separating patients into groups and for finding characteristic, VEA-related events in the ECG data.The third step examined the reproducibility of the onedimensional distributions over time. Using ten-hour ECG tapes, it was found that in 7 of 10 patients the patient-specific distribution, although modulated in amplitude, maintained a similar shape over the ten hours.The VEA characterization which has been developed goes significantly beyond the simple counting of ectopic beats. The distributions can be considered a kind of "fingerprint" of the VEA-generating mechanism -a "fingerprint" which may be useful in the selection and evaluation of therapy.

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“…These studies are of little practical importance for GPs since arrhythmias do not always result in a consultation, and the diagnostic and prognostic value of clinical findings in patients may depend on the selected population (2,4,9). Besides, many of the population-based studies have been done with 24-hour ambulatory ECG, and there is poor correlation between arrhythmias detected by long-term ECG and a standard 12-lead ECG (3, 8,10). Data about the occurrence of arrhythmias are of utmost importance for the GP because his diagnostic procedure is based on the prior probability of the occurrence (1 1).…”

mentioning

confidence: 99%