Long-term prognostic significance of right bundle-branch morphology ventricular ectopy induced during stress test in patients with intermediate to high probability of coronary artery disease

Bière, Loïc; Mezdad, Tin-Hinan; Dupuis, Jean‐Marc; Vallar, Laurent; H, Rakotonirina; Prunier, Fabrice; Furber, Alain

doi:10.1093/europace/euw413

Cited by 3 publications

(2 citation statements)

References 28 publications

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“…In other studies, PVCs during exercise stress testing (EiPVCs) were associated with mortality in patients without cardiovascular and/or valvular heart disease [ 43 ], and in patients with known CAD or idiopathic CMP [ 77 ] during the 14-year follow-up period. Moreover, among patients referred for single-photon emission computed tomography (SPECT), the presence of EiPVCs was a risk factor for mortality in patients with preserved (> 50%) LVEF (OR 2.17, 95% CI 1.09–4.34) [ 78 ]. Multiform PVCs and >12 PVCs/day during a 24-hour Holter recording increased the risk of mortality by 1.5-fold among patients with suspected arrythmia with syncope and palpitations during 10-year follow-up [ 71 , 75 ].…”

Section: Resultsmentioning

confidence: 99%

Diagnostic and prognostic significance of premature ventricular complexes in community and hospital-based participants: A scoping review

Suba

Fleischmann²,

Schell-Chaple³

et al. 2021

PLoS ONE

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Background While there are published studies that have examined premature ventricular complexes (PVCs) among patients with and without cardiac disease, there has not been a comprehensive review of the literature examining the diagnostic and prognostic significance of PVCs. This could help guide both community and hospital-based research and clinical practice. Methods Scoping review frameworks by Arksey and O’Malley and the Joanna Briggs Institute (JBI) were used. A systematic search of the literature using four databases (CINAHL, Embase, PubMed, and Web of Science) was conducted. The review was prepared adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Review (PRISMA-ScR). Results A total of 71 relevant articles were identified, 66 (93%) were observational, and five (7%) were secondary analyses from randomized clinical trials. Three studies (4%) examined the diagnostic importance of PVC origin (left/right ventricle) and QRS morphology in the diagnosis of acute myocardial ischemia (MI). The majority of the studies examined prognostic outcomes including left ventricular dysfunction, heart failure, arrhythmias, ischemic heart diseases, and mortality by PVCs frequency, burden, and QRS morphology. Conclusions Very few studies have evaluated the diagnostic significance of PVCs and all are decades old. No hospital setting only studies were identified. Community-based longitudinal studies, which make up most of the literature, show that PVCs are associated with structural and coronary heart disease, lethal arrhythmias, atrial fibrillation, stroke, all-cause and cardiac mortality. However, a causal association between PVCs and these outcomes cannot be established due to the purely observational study designs employed.

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Section: Resultsmentioning

confidence: 99%

Diagnostic and prognostic significance of premature ventricular complexes in community and hospital-based participants: A scoping review

Suba

Fleischmann²,

Schell-Chaple³

et al. 2021

PLoS ONE

View full text Add to dashboard Cite

show abstract

“…In patients with mid-to-high pre-test probability of CAD and stress-induced ectopies from the LV, SPECT can predict epicardial vessel stenosis, even in the absence of LV systolic dysfunction. 119 Nonetheless, NCEs are not currently recommended by the ESC in the diagnostic workup of CAD-related VA. 3 Instead, FDG-PET has a recognized role in diagnosing both cardiac and extracardiac sarcoidosis. 3 In addition, FDG-PET scan has been proved clinically helpful in lymphocytic myocarditis with VA, in particular when CMR is contraindicated or unsuitable due to ICD-related artefacts.…”

Section: Cardiac Imaging For Ventricular Arrhythmias Proceduresmentioning

confidence: 99%

Twenty-five years of research in cardiac imaging in electrophysiology procedures for atrial and ventricular arrhythmias

Berruezo,

Penela,

Jáuregui

et al. 2023

Europace

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Catheter ablation is nowadays considered the treatment of choice for numerous cardiac arrhythmias in different clinical scenarios. Fluoroscopy has traditionally been the primary imaging modality for catheter ablation, providing real-time visualization of catheter navigation. However, its limitations, such as inadequate soft tissue visualization and exposure to ionizing radiation, have prompted the integration of alternative imaging modalities. Over the years, advancements in imaging techniques have played a pivotal role in enhancing the safety, efficacy, and efficiency of catheter ablation procedures. This manuscript aims to explore the utility of imaging, including electroanatomical mapping, cardiac computed tomography, echocardiography, cardiac magnetic resonance, and nuclear cardiology exams, in helping electrophysiology procedures. These techniques enable accurate anatomical guidance, identification of critical structures and substrates, and real-time monitoring of complications, ultimately enhancing procedural safety and success rates. Incorporating advanced imaging technologies into routine clinical practice has the potential to further improve clinical outcomes of catheter ablation procedures and pave the way for more personalized and precise ablation therapies in the future.

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Are Exercise-Induced Premature Ventricular Contractions Associated with Significant Coronary Artery Disease?

Bun,

Massimelli,

Scarlatti

et al. 2024

JCM

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Objectives: Exercise-induced premature ventricular contractions (EIPVC) have been associated with higher mortality, but the association with coronary artery disease (CAD) has not been precisely established. Our objective was to assess in a group of subjects with EIPVC and cardiovascular risk factors the association with underlying significant coronary artery disease (CAD), in comparison with a control group of patients with cardiovascular risk factors and exercise test (ET) showing ischaemia. Methods: All the patients (above 35 years old) referred for ET at our institution were prospectively included. Patients with at least one cardiovascular risk factor and without known CAD were divided into 2 groups: group A if EIPVC were present (either during exercise or during recovery), at least more than 10% over 30 s of recording; group B if ET was showing ischaemia. The presence of CAD was then confirmed in both groups by coronary arteriography, and/or thallium scintigraphy, and/or cardiac MRI and/or coronary CT angiography performed within 2 months after ET realization. Results: From November 2020 to December 2022, 4098 ETs were performed. After exclusion (normal ETs = 2194; known CAD = 1109; age < 35 years old = 487; congenital heart disease = 59; mitral valve prolapse = 4), 46 patients with EIPVC were finally identified (male 65%, mean age 61.5 ± 11 years), and 71 in group B. CAD was confirmed using additional tests in 5/46 (11%) patients in group A versus 38/71 (54%) in group B (p < 0.0001). Conclusions: Amongst patients without known CAD, the presence of EIPVC was less frequently associated with an underlying CAD, compared to the presence of exercise-induced “electrical” ischaemia.

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Long-term prognostic significance of right bundle-branch morphology ventricular ectopy induced during stress test in patients with intermediate to high probability of coronary artery disease

Abstract: Stress-induced right bundle-branch block morphology VE is associated with an increased mortality in patients with preserved LVEF.

Cited by 3 publications

References 28 publications

Diagnostic and prognostic significance of premature ventricular complexes in community and hospital-based participants: A scoping review

Diagnostic and prognostic significance of premature ventricular complexes in community and hospital-based participants: A scoping review

Twenty-five years of research in cardiac imaging in electrophysiology procedures for atrial and ventricular arrhythmias

Are Exercise-Induced Premature Ventricular Contractions Associated with Significant Coronary Artery Disease?

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