Abstract
Premature ventricular contraction (PVC), a common arrhythmia affecting 1–2% of the general population, has been considered to have a benign clinical course. However, people with PVC often develop heart failure and ventricular arrhythmias such as ventricular tachycardia. We aimed to clarify the risk of heart failure and lethal ventricular arrhythmias in people with PVC. The Korean National Health Insurance Service database was used for this study. People who underwent nationwide health check-ups in 2009 were enrolled in this study and clinical follow-up data until December 2018 were analyzed. Newly diagnosed PVC in 2009 (≥ 1 inpatient or outpatient claim) were identified and cumulative incidence of heart failure (≥ 1 inpatient claim) and ventricular arrhythmias (≥ 1 inpatient or outpatient claim) were compared. A total of 4515 people were first diagnosed with PVC in 2009 among 9,743,582 people without prior history of PVC, heart failure, or ventricular arrhythmias. People with newly diagnosed PVC in 2009 had a significantly higher incidence of heart failure compared to those without PVC [adjusted hazard ratio (HR) 1.371; 95% confidence interval (CI) 1.177–1.598; p < 0.001]. Significant interaction was observed between age and PVC with young age people at greater risk of developing heart failure for having PVC. The incidence of ventricular arrhythmia was also significantly increased in people with PVC (HR 5.588; 95% CI 4.553–6.859; p < 0.001). Age and chronic kidney disease had significant interactions with PVC. In conclusion, the incidence of heart failure and ventricular arrhythmia was significantly increased in people with PVC. Outpatient follow-up of people with PVC can be helpful to detect early signs of heart failure or advanced forms of ventricular arrhythmia.
Highlights
Premature ventricular contraction (PVC), a common arrhythmia affecting 1–2% of the general population, has been considered to have a benign clinical course
We aimed to evaluate the incidence of heart failure and lethal ventricular arrhythmias (VT, ventricular flutter, and ventricular fibrillation (VF)) in people with and without PVC using the Korean National Health Insurance Service (K-NHIS) database
Both PVC: (1) one outpatient record (PVC 1) (HR 3.573; 95% confidence interval (CI) 2.467–5.176; p < 0.001; Table 2 and Fig. 3b) and PVC 2 (HR 7.420; 95% CI 5.805–9.484; p < 0.001; Table 2 and Fig. 3b) were associated with significantly increased risk of ventricular arrhythmia composite and PVC 2 was associated with greater risk of ventricular arrhythmia composite as compared to people with PVC 1
Summary
Premature ventricular contraction (PVC), a common arrhythmia affecting 1–2% of the general population, has been considered to have a benign clinical course. People with PVC often develop heart failure and ventricular arrhythmias such as ventricular tachycardia. We aimed to clarify the risk of heart failure and lethal ventricular arrhythmias in people with PVC. The incidence of ventricular arrhythmia was significantly increased in people with PVC (HR 5.588; 95% CI 4.553–6.859; p < 0.001). The incidence of heart failure and ventricular arrhythmia was significantly increased in people with PVC. Abbreviations AF Atrial fibrillation BMI Body mass index HR Hazard ratio ICD International Classification of Disease K-NHIS Korean National Health Insurance Service PVC Premature ventricular contraction VF Ventricular fibrillation VT Ventricular tachycardia. We aimed to evaluate the incidence of heart failure and lethal ventricular arrhythmias (VT, ventricular flutter, and VF) in people with and without PVC using the Korean National Health Insurance Service (K-NHIS) database
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