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Correlation of left ventricular wall motion abnormalities with ventricular arrhythmias in patients with coronary
Insights
Ventricular arrhythmias, or irregular heartbeats, are more common and complex in symptomatic coronary artery disease patients with impaired left ventricular function. This includes conditions like left ventricular aneurysms, which significantly increase arrhythmia risk.
Area of Science:
- Cardiology
- Cardiac Electrophysiology
Background:
- Symptomatic coronary artery disease (CAD) is often associated with left ventricular dysfunction.
- Ventricular arrhythmias pose a significant risk in patients with CAD.
- The relationship between the extent of left ventricular dysfunction and ventricular arrhythmias requires further elucidation.
Purpose of the Study:
- To investigate the correlation between the degree of left ventricular dysfunction and the incidence and complexity of ventricular arrhythmias.
- To assess if specific patterns of left ventricular dysfunction, such as aneurysms or hypokinesis, are linked to a higher burden of arrhythmias in symptomatic CAD patients.
Main Methods:
- A cohort of 71 symptomatic coronary artery disease patients underwent 12-hour Holter monitoring.
- Cardiac catheterization was performed within 3 months of Holter monitoring to assess left ventricular function.
- Patients were categorized based on left ventricular angiography findings: aneurysms, normal ventricles, or hypokinesis/akinesis without dyskinesis.
Main Results:
- Patients with left ventricular aneurysms exhibited significantly higher rates of heart failure, prior myocardial infarction, cardiomegaly, and reduced ejection fractions compared to those with normal ventricles.
- The mean number of premature ventricular contractions per hour was substantially higher in patients with left ventricular aneurysms (34 +/- 52) compared to those with normal left ventricles (3 +/- 5).
- Complex premature ventricular contractions were observed in 50% of patients with left ventricular aneurysms, versus 10% in normal ventricles and 23% in hypokinesis/akinesis groups.
Conclusions:
- Ventricular arrhythmias, both in incidence and complexity, increase proportionally with the severity of left ventricular wall motion abnormalities in symptomatic coronary artery disease patients.
- Left ventricular aneurysms represent a significant risk factor for developing more frequent and complex ventricular arrhythmias.
Abstract:
We studied 71 patients with 12-hour Holter monitoring to determine if the incidence and complexity of ventricular arrhythmias in symptomatic coronary artery disease patients were related to the extent of left ventricular dysfunction. Their average age was 51 years, and each had cardiac catheterization within 3 months of study. Thirty-six patients had left ventricular aneurysms, 10 had normal left ventricular angiograms and 25 had left ventricular hypokinesis or akinesis without dyskinesis. The patients with aneurysms had significantly more heart failure, prior infarction, cardiomegaly and impaired ejection fractions. The mean premature ventricular contractions per hour for the aneurysm patients was 34 +/- 52, 3 +/- 5 for those with normal left ventricles, and 11 +/- 24 in the remainder. Complex premature ventricular contraction were noted in 50% of the aneurysm patients, in 10% of the patients with normal left ventricles and in 23% of the patients with hypokinesis or akinesis. Ventricular arrhythmias increase with greater left ventricular wall motion abnormality in patients with symptomatic coronary artery disease.