Premature beats in healthy subjects 40-79 years of age.

Abstract

In order to determine the prevalence and complexity of premature beats (PBs) in an adult population without apparent heart disease, 260 healthy subjects 40–79 years of age had a 24 h ambulatory ECG recording performed. A total of 221 subjects (87%) had one or more atrial premature beats (APBs) in the 24 h period, which was statistically significantly more than the number of subjects (179 or 69%) with ventricular premature beats (VPBs). Only 19 subjects (7%) had no PBs. More than 200 VPBs/24 h were seen in only 5% of the subjects, and a similar percentage had more than 200 APBs/24 h. There was a statistically significant increase in the number of VPBs as well as APBs with an increase in age. Multiform VPBs, VPB pairs, multiform APBs and atrial tachycardia (AT) were ‘normal’findings (seen in more than 5% of the subjects), whereas > 2 different VPB configurations, > 2 episodes of VPB pairs, ventricular bigeminy, R-on-T VPBs, ventricular tachycardia, > 2 episodes of AT and AT with more than 10 beats per episode were ‘abnormal’ findings (seen in less than 5% of the subjects). The number of VPBs was almost identical in two 24 h ECG recordings obtained at a mean interval of 22 months in 17 out of 22 subjects studied. Only two out of 22 had a significant change in the number of VPBs/24 h over the 22 month period. As a ‘normal’ range for the number of APBs as well as VPBs per 24 h a figure of 200 is proposed, and it is concluded that most complex types of PBs may occur as incidental findings in healthy adult subjects, but usually in small numbers.