Association between ventricular premature contraction burden and ventricular repolarization duration
1Mersin City Training and Research Hospital, Department of Cardiology - Mersin, Turkey.
Insights
Increased Tp-Te interval and widened QRS-T angle are linked to frequent premature ventricular contractions (PVCs). These ECG markers may help predict PVC burden in patients without 24-hour Holter monitoring.
Area of Science:
- Cardiology
- Electrophysiology
- Cardiac Arrhythmias
Background:
- Premature ventricular contractions (PVCs) are often benign but can indicate left ventricular dysfunction or arrhythmias.
- Myocardial electrical heterogeneity, due to differing ventricular repolarization, is implicated in ventricular arrhythmias.
- Evaluating repolarization parameters may offer insights into PVC frequency and associated risks.
Purpose of the Study:
- To assess the association between ventricular repolarization parameters (Tp-Te interval, Tp-Te/QT ratio, QRS-T angle) and PVC frequency.
- To differentiate repolarization characteristics in patients with high PVC burden versus those with low PVC burden.
Main Methods:
- A cohort of 80 patients undergoing 24-hour Holter monitoring was analyzed.
- Patients were stratified into two groups: high PVC burden (≥1% PVCs) and low PVC burden (<1% PVCs).
- Electrocardiographic parameters including Tp-Te interval, Tp-Te/QT ratio, and QRS-T angle were measured.
Main Results:
- The high PVC burden group exhibited significantly prolonged Tp-Te intervals (85.3±13.9 vs. 65.7±11.9, p<0.001).
- The Tp-Te/QT ratio was also significantly higher in the high PVC burden group (0.19±0.03 vs. 0.15±0.02, p<0.001).
- A statistically significant abnormal QRS-T angle was observed in patients with a high PVC burden (p=0.024).
Conclusions:
- Prolonged Tp-Te interval and widened QRS-T angle correlate with increased PVC frequency.
- These ECG findings may serve as predictors for PVC burden.
- Electrocardiography parameters could potentially guide risk stratification in PVC patients, even without continuous monitoring.
Objective:
Premature ventricular contraction is generally known as benign in the absence of structural heart disease; however, premature ventricular contraction-induced left ventricular systolic dysfunction or ventricular arrhythmias are defined in some cases. Ventricular repolarization duration differs between myocardial cells, which causes myocardial electrical heterogeneity and is thought to be responsible for ventricular arrhythmias. In our study, we aimed to evaluate the association of ventricular repolarization parameters including Tp-Te interval, Tp-Te/QT ratio, and QRS-T angle with premature ventricular contraction frequency in patients with premature ventricular contraction burden.
Methods:
A total of 80 subjects who were admitted to our cardiology department and underwent 24-h electrocardiography Holter monitoring were included. Patients were divided into two groups: group 1 is defined as premature ventricular contraction burden that had frequent premature ventricular contraction ≥1% in 24-h Holter monitoring, and group 2 is defined as rare premature ventricular contraction <1% in 24-h Holter monitoring.
Results:
Tp-Te interval and Tp-Te/QT ratio are statistically significantly prolonged in the premature ventricular contraction burden group than in the control group (85.3±13.9 vs. 65.7±11.9, p<0.001; 0.19±0.03 vs. 0.15±0.02, p<0.001, respectively). QRS-T angle was statistically significantly abnormal in the premature ventricular contraction burden group (p=0.024).
Conclusion:
Increased Tp-Te interval and widened QRS-T angle are associated with ventricular arrhythmias and might be used for the prediction of premature ventricular contraction burden in patients with premature ventricular contraction in electrocardiography in the absence of 24-h Holter monitoring.
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