Ventricular arrhythmias are not a short-term reproducible phenomenon – why long recording monitoring is necessary

Abstract

BackgroundThe variability of ventricular arrhythmias (VA) among different days of the week is not well detected by one-day Holter monitoring. AimsTo evaluate whether there are differences in VA distribution pattern during long recording period. MethodsThe EKG was recorded for 14h per day during 7days by Holter system in 34 consecutive pat ventricular couplets and non-sustained ventricular tachycardia (NSVT) recording from patients provided graphic data. We applied the Hurst method (H Coefficient) which evaluates whether a repetitive phenomenon is random or not. When the H is >0.5 and <1 means it is not random and implies a long-term memory effect. Considering the arrhythmic variability, the data were also analyzed by repetitive ANOVA comparing incidence of arrhythmias among the days. ResultsIsolated PVCs and ventricular couplets during 98h recording provided graphic of the occurrence. A trend of increasing and decreasing of arrhythmias was observed which looks erratic. The H coefficient, however, was significantly >0.5 for all patients. Repeated ANOVA showed statistic difference among days in 31 patients with isolated PVCs; in 26 with ventricular couplets and 19 with NSVT when analyzed per hour during week days (p < 0.05). ConclusionPVCs, ventricular couplets and NSVT are not a random phenomenon. Our data suggest the occurrence of ventricular arrhythmias had no similarity among the days, making unlikely that a single Holter recording for 24h may capture this phenomenon.