Coupling Interval Ratio to Predict the Beta-Blocker Response Against Premature Ventricular Complexes.

Area of Science:

• Cardiology
• Electrophysiology
• Pharmacology

Background:

• Beta-blockers are widely used for premature ventricular complexes (PVCs) but exhibit unpredictable efficacy.
• Identifying predictors of beta-blocker response is essential for optimizing treatment of PVCs.
• Holter-guided electrocardiographic criteria may offer insights into treatment responsiveness.

Purpose of the Study:

• To identify Holter-guided electrocardiographic criteria that predict beta-blocker responsiveness in patients with PVCs.
• To evaluate the association between heart rate variability, coupling intervals (CIs), and beta-blocker treatment outcomes for PVCs.

Main Methods:

• Retrospective analysis of 89 patients with pre- and post-treatment Holter electrocardiogram recordings.
• Screening of Holter recordings for heart rate variability, PVC burden, heart rate, and pre- and post-coupling intervals (CIs) across three time intervals.
• Definition of beta-blocker responders based on a 70% decrease in PVC burden.

Main Results:

• No statistically significant differences in heart rate variability between responder and non-responder groups.
• A statistically significant difference in CI ratio between groups during the 24:00-08:00 am interval (3.19 vs. 2.91, P = 0.006).
• Nighttime increased CI ratio (shorter CI time) was an independent predictor of beta-blocker response for PVCs (OR, 9.54; P = 0.006).

Conclusions:

• Nighttime coupling interval ratio is a significant predictor of beta-blocker responsiveness in PVCs.
• Beta-blockers may be particularly beneficial for patients with PVCs exhibiting shorter nighttime CIs or increased nighttime CI ratios.
• Holter-guided CI analysis can aid in tailoring beta-blocker therapy for PVC management.