Long-term outcome of multiform premature ventricular complexes in structurally normal heart

Lin, Chin Yu; Chang, Shih Lin; Lin, Yenn Jiang; Lo, Li Wei; Chen, Yun Yu; Chao, Tze Fan; Hu, Yu Feng; Tuan, Ta Chuan; Liao, Jo Nan; Huang, Yen Chang; Chang, Yao‐Ting; Chiou, Chuen Wang; Chen, Shih Ann

doi:10.1016/j.ijcard.2014.11.110

Cited by 71 publications

(84 citation statements)

References 22 publications

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“…Patients who did not take regular medication were followed up annually or at the discretion of the physicians. Medical records retrieved from the Taipei Veterans General Hospital were used for outcome survey as in our previous study 8. New cardiovascular events, inpatient admissions, and deaths were identified through the ICD diagnostic codes, mention of an end point on the face sheet of the medical record, previous discharge summary, and outpatient clinic reports.…”

Section: Methodsmentioning

confidence: 99%

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Intermediate Pause at Daytime Is Associated With Increased Cardiovascular Risk and Mortality: An 8‐Year Cohort Study

Liu

Lin

Chang

et al. 2018

JAHA

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BackgroundLong‐term cardiovascular risk in patients with intermediate pauses remains unclear. Whether asymptomatic patients with intermediate pauses have increased future cardiovascular events remains unknown. We hypothesize that intermediate pause is associated with increased cardiovascular risk and mortality.Methods and ResultsWe retrospectively analyzed 5291 patients who have pauses of <3 seconds on 24‐hour Holter monitoring. Patients with pauses of 2 to 3 seconds constitute the intermediate pause patients, who are further divided into daytime pause (8:00 am–8:00 pm), nighttime pause (8:00 pm–8:00 am), and daytime plus nighttime pause groups depending on the occurring time of the pauses. The rest of the patients (pause <2 seconds) are the no pause group. The multivariate Cox hazards regression model was used to assess the hazard ratio for mortality (primary outcome) and adverse cardiovascular events (secondary outcome). There were 4859 (91.8%) patients in no pause, 248 (4.7%) in nighttime pause, 103 (1.9%) in daytime pause, and 81 (1.5%) in daytime plus nighttime pause groups. After a follow‐up of 8.8±1.7 years’ follow‐up, 343 (6.5%) patients died. The risk for adverse cardiovascular events, including all‐cause hospitalization, cardiovascular‐cause hospitalization, pacemaker implantation, new‐onset atrial fibrillation/heart failure, and transient ischemic attack, were higher in daytime pause and nighttime pause patients than those in the no pause group. Daytime pause (hazard ratio, 2.35; P=0.008) and daytime plus nighttime pause (hazard ratio, 2.26; P=0.016) patients have a higher mortality rate than that in nighttime pause.ConclusionsPatients with intermediate pause are associated with increased cardiovascular risk. Intermediate pauses occurring at daytime have a higher mortality rate than that at nighttime during long‐term follow‐up.

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Section: Methodsmentioning

confidence: 99%

“…The 24‐hour Holter monitoring data were reviewed by electrophysiological experts as in our previous work 8. Patients with intermediate pauses (the longest R‐R interval of ≥2 and <3 seconds) constituted the study group.…”

Section: Methodsmentioning

confidence: 99%

Intermediate Pause at Daytime Is Associated With Increased Cardiovascular Risk and Mortality: An 8‐Year Cohort Study

Liu

Lin

Chang

et al. 2018

JAHA

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“…This retrospective, observational study was based on the database of Registry of 24-hour ECG monitoring at Taipei Veterans General Hospital. 9 Taipei Veterans General Hospital is a large tertiary referring medical center providing comprehensive medical services to >6 million populations in north Taiwan. A total of 5903 consecutive patients, who were >18 years of age, were referred for 24-hour Holter monitoring between January 1, 2002, andDecember 31, 2004, for the following indications: palpitations, syncope, and suspected arrhythmia; hospitalized patients were excluded from the study.…”

mentioning

confidence: 99%

“…Clinical features for these patients, including past medical history, comorbidities, and medications, were obtained from hospital discharge diagnoses, outpatient visits, emergency visits, and the Collaboration Center of Health Information Application, Ministry of Health and Welfare in Taiwan. [9][10][11] The exclusion criteria in our study were as follows: participants with past history of stroke, permanent pacemaker, catheter ablation, pulmonary hypertension or hypertrophic cardiomyopathy, and valvular heart disease. In addition, patients with AF/atrial flutter and any supraventricular ectopic beats >5 seconds in this Holter study were excluded.…”

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confidence: 99%

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Risk of Stroke in Patients With Short-Run Atrial Tachyarrhythmia

Yamada

Lin

Chang³

et al. 2017

Stroke

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Background and Purpose-The risk of stroke in patients with short-run atrial tachyarrhythmia (AT) remains unclear. This study aimed to investigate the relationship between short-run AT and the stroke and the use of the CHA 2 DS 2 -VASc score for the risk stratification. Methods-From the registry of 24-hour Holter monitoring, 5342 subjects without known atrial fibrillation or stroke were enrolled. Short-run AT was defined as episodes of supraventricular ectopic beats <5 seconds. Results-There were 1595 subjects (29.8%) with short-run AT. During the median follow-up period of 9.0 years, 494 subjects developed new-onset stroke. Patients with short-run AT had significantly higher stroke rates compared with patients without short-run AT (11.4% versus 8.3%; P<0.001). In patients with short-run AT, the number of strokes per 100 person-years for patients with CHA 2 DS 2 -VASc score of 0 and 1 were 0.23 and 0.67, respectively. However, the number of them for patients with CHA 2 DS 2 -VASc score of 2, 3, 4, and ≥5 were 1. . Conclusions-Short-run AT increases the risk of stroke. Therefore, the CHA 2 DS 2 -VASc score could be used for the risk stratification. Age and burden of premature atrial contractions were independent predictors for stroke in patients with CHA 2 DS 2 -VASc score of 0 or 1.

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Association of premature ventricular complexes and risk of ischemic stroke: A systematic review and meta‐analysis

Rujirachun

Wattanachayakul

Phichitnitikorn

et al. 2020

Clinical Cardiology

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Recent studies have suggested that patients with premature ventricular complexes (PVCs) may have a higher risk of ischemic stroke. However, the data are limited and inconclusive. We conducted a systematic review and meta‐analysis to investigate the association between PVCs and the risk of ischemic stroke. A comprehensive literature review was conducted by searching for published articles indexed in MEDLINE and EMBASE databases from inception through September 25, 2020, to identify studies that compared the risk of ischemic stroke between patients with PVCs and individuals without PVCs. Pooled risk ratio (RR) and 95% confidence interval (CI) were calculated using a random‐effect, generic inverse variance method of Dersimonian and Laird. A total of four observational studies (2 prospective and 2 retrospective cohort studies) with 42 677 participants met the eligibility criteria and were included in the meta‐analysis. We found that patients with PVCs have a significantly higher risk of ischemic stroke than individuals without PVCs with the pooled RR of 1.31 (95% CI, 1.07–1.60, I2 = 43%). From our systematic review and meta‐analysis, we found that PVCs are associated with a higher risk of ischemic stroke. Whether this association is causal and how it should be addressed in clinical practice require further investigations.

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Long-term outcome of multiform premature ventricular complexes in structurally normal heart

Cited by 71 publications

References 22 publications

Intermediate Pause at Daytime Is Associated With Increased Cardiovascular Risk and Mortality: An 8‐Year Cohort Study

Intermediate Pause at Daytime Is Associated With Increased Cardiovascular Risk and Mortality: An 8‐Year Cohort Study

Risk of Stroke in Patients With Short-Run Atrial Tachyarrhythmia

Association of premature ventricular complexes and risk of ischemic stroke: A systematic review and meta‐analysis

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