Clinical implication of surface morphology of ventricular premature contractions

VPC morphology was studied in the surface 12-leads ECGs (resting) in one hundred and thirty-six patients over a none-month period (January-September, 1978). Seventy four (54%) of these had coronary artery disease proven by cardiac catheterization (61) or by evidence of acute transmural myocardial infarction (13) diagnosed by ECG and serum enzyme study. Twenty-three of the patients (17%) had other organic heart diseases documented by cardiac catheterization. The remaining thirty-nine (29%) were healthy individuals. Three common types of VPCs are recognized as right, left and septal in origin. There is no significant difference in the prevalence of these types in the presence of heart disease (right, 35%, left 31%, and septal 34%). However if septal VPCs are considered along with left VPCs, these are twice as common as right VPCs. VPCs occurring in healthy individuals are overwhelmingly (74%) right ventricular in origin. In general, VPCs are most likely to occur in the presence of ventricular dyssynergy and multiple coronary arterial lesions.