Related Experiment Videos
Concealed ventricular extrasystoles. A family of premature ventricular complexes with high spontaneous variability
Gaetano Satullo1, Antonino Donato, Giuseppe Busà
1Division of Cardiology, Papardo Hospital, Messina, Italy. gsatullo@tiscalinet.it
Insights
Concealed ventricular extrasystoles exhibit significant spontaneous variability, unlike randomly distributed premature ventricular complexes (PVCs). This suggests they are not transient but a persistent marker of specific PVC patterns.
Area of Science:
- Cardiology
- Electrophysiology
Background:
- Concealed ventricular extrasystoles feature cyclical premature beats after regular sinus beats.
- The variability and stability of their distribution remain undefined.
Purpose of the Study:
- To assess variability differences between concealed ventricular extrasystoles and random premature ventricular complexes (PVCs).
Main Methods:
- Evaluated PVC distribution in 39 patients with frequent monomorphic PVCs via 24-hour ambulatory monitoring.
- Divided patients into groups with concealed extrasystoles (A) and random PVCs (B).
- Conducted a second ECG monitoring within 30-360 days for comparison.
Main Results:
- No significant difference in the overall number of PVCs between groups.
- Group A (concealed extrasystoles) showed high spontaneous variability (p=0.006) between monitoring sessions.
- Group B (random PVCs) did not exhibit significant variability.
Conclusions:
- Concealed ventricular extrasystoles are not random but indicate a PVC pattern with potential for long-term stability or sudden disappearance.
- These findings highlight the distinct nature and behavior of concealed ventricular extrasystoles.
Background:
The term concealed ventricular extrasystoles defines a phenomenon in which premature beats have a cyclical distribution and manifest after a predictable number of intervening sinus beats. The extent of its spontaneous variability as well as the stability of its orderly distribution, however, have not been defined yet. The aim of this study was to assess whether there is any difference between the variability of concealed ventricular extrasystoles and their allorhythmic patterns.
Methods:
The distribution of premature ventricular complexes (PVCs) was evaluated in 39 patients with frequent monomorphic PVCs (> 1000/die) during a baseline 24-hour ambulatory monitoring electrocardiogram. Patients were divided into two groups: group A had evidence of concealed ventricular extrasystoles, while in group B PVCs were randomly distributed. All patients underwent a second ambulatory monitoring electrocardiogram within 30-360 days.
Results:
The overall number of PVCs did not differ between the groups. Patients of group A showed a very high spontaneous variability (p = 0.006) between the first and the second ambulatory monitoring electrocardiogram, whereas significant differences were not observed among patients of group B.
Conclusions:
Concealed ventricular extrasystoles are not casual and transient, but should be regarded as a marker of a "family" of PVCs that have the tendency either to maintain their orderly distribution for long periods or to disappear suddenly.