Premature ventricular complexes and migraine: insights from Holter monitoring during pain-free intervals

Migraine is a common neurological disorder associated with an increased risk of cardiovascular conditions, including arrhythmias. Although autonomic dysfunction is considered a key mechanism linking migraine and cardiac abnormalities, its impact during pain-free intervals remains unclear.To investigate the association between migraine and cardiac arrhythmias, focusing on the prevalence of premature ventricular contractions (PVCs) and autonomic dysfunction during pain-free periods.A total of 50 migraine patients and 51 age- and sex-matched healthy controls were enrolled in the present observational, cross-sectional study. All participants underwent 24-hour Holter monitoring, standard electrocardiographic and echocardiographic evaluation. The frequencies of PVCs, PR interval, QT interval (QTc), heart rate variability, and sinus tachycardia prevalence were compared between groups. Migraine-related disability was assessed using the Migraine Disability Assessment Scale (MIDAS) and the Headache Impact Test-6 (HIT-6).At least 1 PVC was detected in 40% of migraine patients, although no significant difference was observed compared with controls (p > 0.05). However, migraine patients showed a significantly higher prevalence of sinus tachycardia (p < 0.05). Additionally, a positive correlation was found between PVC burden and MIDAS scores, suggesting a potential link between migraine severity and arrhythmia risk. No significant differences were observed in QTc intervals or other major arrhythmic parameters.Migraine patients may exhibit increased sinus tachycardia and subtle electrocardiographic changes even during pain-free intervals, possibly reflecting underlying autonomic dysfunction.