Distribution patterns of ventricular premature complexes at different heart rates

Area of Science:

• Cardiology
• Cardiac Electrophysiology
• Computational Medicine

Background:

• Ventricular premature complexes (VPCs) are common arrhythmias.
• Understanding VPC distribution patterns in relation to heart rate is crucial for diagnosing and managing cardiac conditions.
• Holter monitoring provides extensive data on heart rate variability and arrhythmias.

Purpose of the Study:

• To analyze the relationship between VPC distribution patterns and heart rate during Holter recordings.
• To identify specific heart rate zones associated with different VPC coupling behaviors (bigeminy, trigeminy).
• To explore the underlying electrophysiological mechanisms of observed VPC patterns.

Main Methods:

• Utilized computer-assisted analysis of Holter recordings with abundant VPCs.
• Determined the number of interectopic sinus beats at various heart rates.
• Identified and characterized manifest and concealed bigeminy and trigeminy zones within the 24-hour heart rate spectrum.

Main Results:

• Demonstrated distinct heart rate zones for bigeminy and trigeminy patterns in a significant proportion of patients (26% and 21% respectively).
• Observed bigeminy zones at significantly lower average heart rates compared to trigeminy zones.
• Found co-occurrence of both bigeminy and trigeminy zones in 10 out of 42 patients.

Conclusions:

• Bigeminy and trigeminy zones likely represent predicted VPC distribution patterns from pacemaker modulation and reentry.
• These zones may correspond to entrainment zones during electrotonic modulation of parasystolic foci.
• Bigeminy zones suggest 2:1 entrainment, while trigeminy zones indicate primarily 3:1 entrainment, offering insights into arrhythmogenesis.