Quantification of Prevalence of Asymptomatic Ventricular Arrhythmias in Patients with Heart Failure

Abstract

BackgroundVentricular arrhythmias (VAs) are recorded in many patients with chronic heart failure. The present study was designed to prospectively determine and quantify the prevalence of asymptomatic VAs in this patient population.MethodsOne hundred and two patients, 82 men and 20 women (median age 61 years) with NYHA Functional Class II (n = 50, 49%) and III (n = 52, 51%) heart failure were prospectively assessed with 24‐hour ambulatory ECGs.ResultsRare premature ventricular complexes (PVCs) (<100/24 hours) were observed in 22 (21.6%), moderately frequent (101–1000/24 hours) in 31(30.4%), and frequent (>1000/24 hours) in 49 (48.0%) patients. A significantly greater prevalence of <100 PVCs/24 hours was observed in male compared to female patients (P < 0.03) and in those over 61‐years old compared to younger patients (P < 0.01). There was a significantly greater incidence of >0 repetitive PVCs (RPVCs) per 24 hours and >25 RPVCs/24 hours in patients with low ejection fraction (EF), defined as either ≤0.30 (P = 0.003) or ≤ 0.22 (P = 0.02). The occurrence of VT events was significantly associated with EF ≤ 0.30 (P = 0.007). The prevalence of >100 PVCs/24 hours was significantly higher in patients treated with digoxin (P < 0.02).ConclusionsPVCs are more frequently observed and more frequent in number in patients with heart failure than in normal subjects, and arrhythmia severity correlates with severity of left ventricular dysfunction.