Coronary artery diseaseRelation of Atrial and/or Ventricular Premature Complexes on a Two-Minute Rhythm Strip to the Risk of Sudden Cardiac Death (the Atherosclerosis Risk in Communities [ARIC] Study)
Section snippets
Methods
We used public-use data from the Atherosclerosis Risk in Communities (ARIC) study, an ongoing prospective study of the cause and natural history of atherosclerosis funded by the National Heart, Lung, and Blood Institute (NHLBI). Four communities took part in the investigation: Forsyth County, North Carolina; Jackson, Mississippi; suburban Minneapolis, Minnesota; and Washington County, Maryland. The total population of the study, conducted from 1987 to 1989, was 15,732 subjects 45 to 64 years of
Results
The ARIC pubic-use data included 15,732 participants. We excluded 1,158 subjects who had prevalent CHD or stroke at baseline or whose baseline 2-minute electrocardiogram was of poor quality. As a result, our analysis consisted of 14,574 middle-aged Americans free of CHD and stroke at baseline. They were followed to December 31, 2002 for incident cardiac events including SCD, CHD, and fatal CHD, an average of 14 years. Median follow-up time of the study was 14 years (interquartile range 1.5). Of
Discussion
In this prospective study we report 3 major findings. First, presence of any VPC on a 2-minute rhythm strip at baseline was associated with significantly increased risk of SCD, incident CHD, and fatal CHD in middle-aged Americans who did not have a history of CHD or stroke. Furthermore, after fully adjusting for known risk factors, those patients with VPCs were 2 times as likely to develop a fatal CHD or SCD. The similar magnitude of risks is largely due to the significant overlap of incidence
Acknowledgment
We thank the NHLBI, ARIC investigators and participants for their important contributions and also for making available public use data. We extend our thanks to our librarian, Laurie Schwing, MLS and Daniel Fischman, MD, MMM for helping us in editing and producing the final draft.
References (16)
- et al.
Epidemiology of sudden cardiac death: clinical and research implications
Prog Cardiovasc Dis
(2008) Sudden cardiac death: the major challenge confronting contemporary cardiology
Am J Cardiol
(1979)- et al.
Prevalence of premature ventricular complexes in a population of African American and white men and women: the Atherosclerosis Risk in Communities (ARIC) study
Am Heart J
(2002) - et al.
The rhythm of the heart in active elderly subjects
Am Heart J
(1980) - et al.
Cardiac arrhythmias in a healthy elderly population: detection by 24-hour ambulatory electrocardiography
Chest
(1982) - et al.
Usefulness of ventricular premature complexes to predict coronary heart disease events and mortality (from the Atherosclerosis Risk In Communities cohort)
Am J Cardiol
(2006) - et al.
Community surveillance of coronary heart disease in the Atherosclerosis Risk in Communities (ARIC) Study: methods and initial two years' experience
J Clin Epidemiol
(1996) - et al.
Relation between ventricular premature complexes and sudden cardiac death in apparently healthy men
Am J Cardiol
(1987)
Cited by (61)
Evaluation of patients with high burden of premature ventricular contractions by comprehensive transthoracic echocardiography
2022, IJC Heart and VasculatureCitation Excerpt :Premature ventricular contractions (PVCs) are common in clinical practice, both in patients with and without a history of structural heart disease [1–6].
Cardiac Magnetic Resonance in the Evaluation of Patients With Frequent Premature Ventricular Complexes
2022, JACC: Clinical ElectrophysiologyInterpretable morphological features for efficient single-lead automatic ventricular ectopy detection
2021, Journal of ElectrocardiologyRisk stratification in patients with frequent premature ventricular complexes in the absence of known heart disease
2020, Heart RhythmCitation Excerpt :Pace-mapping was performed if the PVCs were infrequent. Successful ablation was defined as reduction of PVC burden by ≥80% compared to preablation.5 Antiarrhythmic medications were discontinued after an acutely successful ablation.
Identifying Premature Ventricular Complexes from Outflow Tracts Based on PVC Configuration: A Machine Learning Approach
2023, Journal of Clinical Medicine