Long-term outcome of multiform premature ventricular complexes in structurally normal heart

Area of Science:

• Cardiology
• Electrophysiology
• Preventive Medicine

Background:

• Premature ventricular complexes (PVCs) are common in hearts without structural abnormalities.
• The prognostic significance of varying PVC morphologies, specifically multiform PVCs, remains incompletely understood.

Purpose of the Study:

• To investigate the predictive value of multiform PVCs for adverse cardiovascular outcomes in patients with structurally normal hearts.

Main Methods:

• Analysis of 24-hour electrocardiography data from 3351 individuals with normal hearts.
• Kaplan-Meier curves and multivariate Cox proportional hazards models were used.
• Comparison of outcomes between patients with multiform PVC, uniform PVC, and no PVCs over a 10-year follow-up.

Main Results:

• Multiform PVCs were associated with increased mortality (HR: 1.642), hospitalization (HR: 1.196), cardiovascular hospitalization (HR: 1.289), new-onset heart failure (HR: 1.456), transient ischemic attack (HR: 1.411), and new-onset atrial fibrillation (HR: 1.546) compared to no PVCs.
• Patients with multiform PVCs had higher mortality (HR: 1.231) and hospitalization rates (HR: 1.147) than those with uniform PVCs.
• Individuals with multiform PVCs were older and had more comorbidities.

Conclusions:

• The presence of multiform PVCs independently predicts a higher risk of mortality, hospitalization, transient ischemic attack, new-onset atrial fibrillation, and new-onset heart failure.
• Multiform PVCs serve as a significant prognostic marker in patients with structurally normal hearts.