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Ventricular ectopic activity in chronic ischaemic heart disease
Insights
This study found that ventricular ectopic beats (VEB) in post-myocardial infarction patients remain stable over time. A simple 1-hour recording can effectively classify patients based on VEB frequency for prognosis.
Area of Science:
- Cardiology
- Electrophysiology
Background:
- Post-myocardial infarction (MI) patients are at risk for arrhythmias.
- Assessing ventricular ectopic activity (VEA) is crucial for risk stratification.
Purpose of the Study:
- To investigate the characteristics and stability of VEA in post-MI patients.
- To propose a classification system for VEA based on frequency.
Main Methods:
- Longitudinal study over 5 years.
- 700 Holter recordings (6-7 hours each) from 116 post-MI patients.
- Classification into Group I (<8 VEB/hour) and Group II (≥8 VEB/hour).
Main Results:
- VEA frequency remained constant over time.
- Repetitive firing and multiformity correlated with absolute VEB number.
- A 6-7-hour recording offered minimal additional information over a 1-hour recording.
- Resting ECG presence of VEB predicted >8 VEB/hour on monitoring.
Conclusions:
- A simple classification of VEA is feasible and clinically relevant.
- Short-term monitoring is sufficient for classifying VEA in post-MI patients.
- VEA patterns provide prognostic information.
Abstract:
Ventricular ectopic activity in 116 consecutive postmyocardial infarction patients was studied. The study extended over a period of 5 years and 700 periodic 6-7-hour Holter tape recordings were perfomred. A classification of ectopic activity is presented and it is suggested that patients be classified into group I with few, i.e. less than 8, and group II with multiple, i.e. 8 or more, ectopic beats per hour. It was found that the frequency of ventricular ectopic activity tends to remain constant over prolonged periods of time, and that repetitive firing as well as multiformity are functions of the absolute number of ventricular ectopic beats (VEB) present. A 6-7-hour sample of ventricular ectopic activity gives only marginally more information than a 1-hour recording, and the presence of VEB on a resting ECG correlates well with a frequency of more than 8 VEB per hour (group II) on extended monitoring.