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Curso de Atualização em Medicina Cardiovascular 2019
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A. Basics
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01. History of Cardiology
02. Clinical Skills
03. Imaging
04. Arrhythmias, General
05. Atrial Fibrillation
06. Supraventricular Tachycardia (non-AF)
07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
09. Device Therapy
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21. Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure
22. Aortic Disease
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28. Risk Factors and Prevention
29. Rehabilitation and Sports Cardiology
30. Cardiovascular Disease in Special Populations
31. Pharmacology and Pharmacotherapy
32. Cardiovascular Nursing
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34. Public Health and Health Economics
35. Research Methodology
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Frequent supraventricular ectopy as an independent risk marker of adverse outcome in patients with frequent premature ventricular contractions
Session:
Posters 1 - Écran 10 - Arritmologia
Speaker:
Leonor Parreira
Congress:
CPC 2019
Topic:
C. Arrhythmias and Device Therapy
Theme:
04. Arrhythmias, General
Subtheme:
04.3 Arrhythmias, General – Diagnostic Methods
Session Type:
Posters
FP Number:
---
Authors:
Leonor Parreira; Rita Marinheiro; Dinis Valbom Mesquita; Pedro Campos Amador; José Maria Farinha; Marta Ferreira Fonseca; Ana Fátima Esteves; Antonio Pinheiro Cumena Candjondjo; Artur Lopes; Duarte Nuno Chambel; Claudia Lopes; Rui Caria
Abstract
<p><strong>Introduction:</strong> Frequent premature ventricular contractions (PVCs) have been associated with an adverse prognosis in patients with heart disease, especially if non-sustained ventricular tachycardias (NSVT) are present.</p> <p><strong>Aims:</strong> The aim of this study was to evaluate if the presence of excessive supraventricular ectopy adds an additional risk of adverse outcome in patients with frequent PVCs.</p> <p><strong>Methods</strong>: We retrospectively evaluated 1967 consecutive 24-hour Holter monitoring performed between 2006 and 2010 in a single center. We selected patients with frequent PVCs defined as more than 40 PVCs/hour. Patients with atrial fibrillation were excluded. We studied two groups according to the further presence of frequent premature atrial contractions (PACs) defined as more than 40 PACs /hour. We evaluated the clinical, echocardiographic and Holter variables. The primary endpoint was cardiac death defined as death due to heart failure, sudden death, or acute coronary syndrome.</p> <p><strong>Results:</strong> We studied 312 patients with more than 40 PVCs/hour. 65 patients had also frequent PACs. Those patients were older (75 (67-80) vs 67 (58-75) years, p<0.0001) and had larger left atrium diameter (45 (40-48) mm vs 38 (35-43) , P<0.0001). The two groups did not differ in relation to the presence of structural heart disease (SHD) and left ventricular function, or other Holter and echocardiographic parameters. During a median follow-up of 46 (20-72) months, 23 patients died of cardiac causes. The presence of frequent PACs was independently associated with the occurrence of cardiac death (the univariable and multivariable analysis are displayed in the Table).</p> <p>Kaplan–Meier estimates of cardiac death during the period of follow-up in both groups are shown in the Figure.</p> <p><strong>Conclusion</strong>: In this group of patients with frequent PVCs, the presence of frequent PACs was independently associated with increased cardiac mortality, thus identifying a subgroup of patients with a worse prognosis.</p>
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