Ventricular arrhythmias during 24-h ambulatory ECG recording: incidence, risk factors and prognosis in men with and without a history of cardiovascular disease.

Abstract

To study incidence, prognosis and risk factors of ventricular arrhythmias in men with and without asymptomatic non-invasively detected cardiovascular disease (CVD). Prospective cohort study with 11 years' follow-up. The subjects went through 24-h ambulatory electrocardiographic (ECG) registrations and non-invasive examinations of leg and carotid arteries at the baseline examination. Malmö, Sweden. Four hundred and forty-three randomly selected 68-year-old men. Mortality and cardiac event rates during an 11-year period. Frequent or complex arrhythmias (Lown class 2-5) were common in men both with and without CVD. However, the associated prognoses were different. In men with CVD, frequent or complex arrhythmias were associated with increased cardiac event rates (P = 0.001) and increased mortality (P = 0.054). This pattern was also found in men with asymptomatic leg and carotid artery disease, although the frequency of arrhythmia in Lown class 2-5 was similar to that in men without CVD. Men with angina pectoris or previous myocardial infarction in combination with leg or carotid artery disease had the most arrhythmias and the worst prognosis. No relationship between frequent or complex arrhythmias and mortality or cardiac events was found in men without CVD. In a logistic regression, smoking and diabetes mellitus were significant and independent determinants of frequent or complex arrhythmias in men with CVD. High alcohol consumption was associated with arrhythmias in men without CVD. Ambulatory ECG recording is a feasible method to improve risk assessment in men with CVD. In this group, frequent or complex arrhythmias are associated with smoking and diabetes mellitus.