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Ventricular ectopy and sudden death

J J Rozanski, A Castellanos, R J Myerburg

    Cardiovascular Clinics
    |January 1, 1980
    PubMed
    Summary
    This summary is machine-generated.

    Complex ventricular arrhythmias increase sudden death risk, especially with heart disease. A 24-hour Holter monitor assessing frequency and complexity offers the best current risk assessment.

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    Area of Science:

    • Cardiology
    • Electrophysiology
    • Preventive Medicine

    Background:

    • Chronic ventricular arrhythmias are independent risk factors for sudden cardiac death.
    • Risk is proportional to the severity of underlying organic heart disease.
    • Current grading systems for arrhythmias include Lown's modified grades and frequency analysis.

    Purpose of the Study:

    • To evaluate the role of ventricular arrhythmias in sudden cardiac death risk.
    • To determine the optimal method for assessing this risk.
    • To discuss current and future treatment strategies for ventricular arrhythmias.

    Main Methods:

    • Analysis of ventricular arrhythmias using a 24-hour Holter monitor.
    • Assessment of both arrhythmia frequency and complexity (Lown's grades).

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  • Review of existing literature on arrhythmia grading and sudden death risk.

    • Main Results:

    • Complex ventricular arrhythmias (Lown's grades 3-5, bigeminy) and high frequency of less complex forms are significant risk factors.
    • A single 24-hour Holter monitor provides a practical compromise for risk assessment.
    • Spontaneous variation in arrhythmia frequency remains an unresolved issue.

    Conclusions:

    • A 24-hour Holter monitor assessing frequency and complexity is the current best method for sudden death risk assessment.
    • Treatment aims to reduce or abolish ventricular arrhythmias; maintaining drug levels may offer protection.
    • Provocative testing methods are under investigation for identifying high-risk individuals.