[Predictive value of sudden death in repetitive ventricular extrasystole]

Prognostic significance of repetitive ventricular premature contractions (RVPC) were evaluated retrospectively in 452 patients studied with a 24 hours continuous electrocardiographic monitoring (Holter System). The patients were analysed in two groups: Group 1.- 199 patients; with primary heart disease: previous myocardial infarction (MI) in 114 patients, angina pectoris (AP) in 29 cases, congestive cardiomyopathy in 19 cases (COCM); hypertensive heart disease (AHCD) in 14 cases, Atherosclerotic heart disease (AEC) with conduction disturbance and without angina pectoris 23 cases. Group 2.- 253 patients without heart disease. Two different types of RVPCs were defined: Type A: as the occurrence of self-terminating two (coupled) or multifocal. RVACs Type B: Self limited ventricular tachycardias or "R on T phenomena". Forty patients of group 1 had RVPCs (23 type A and 17 type B) and 22% of them had sudden death (SD). Among 199 patients with structural heart disease, 74 had congestive heart failure (CHF) and 12 of these had RVPCs. 83% of patients with RVPCs died suddenly. No patients with CHF and without RVPCs had SD. In group 2 (without heart disease no patients died on the follow up, and 6% of them had RVPCs (68% type A and 32% type B). Coronary arteriographic and ventriculographic findings were reviewed in 92 patients with previous MI. In the patients followed 40 has RVPCs, and 9 of them had SD. Those 4 cases were cases of MI (25% of the patients with MI having RVPCs), 4 (25%) with COCM, and 1 (2.5%) with hypertensive cardiac disease. Thus, patients with MI or COCM had higher incidence of RVPCs, so they are at a high risk for sudden cardiac death.