Is the morphology of ventricular premature beats a marker for left ventricular dysfunction?
The morphology of ventricular premature beats has been described as a marker for the presence or absence of myocardial disease. Furthermore, the premature beat has been reported to be a potential marker for a dilated and hypokinetic left ventricle. To verify this previously tested hypothesis, 37 healthy patients with ventricular premature beats on an electrocardiogram (ECG), Holter monitor ECG, or a stress test ECG were classified according to the ventricular premature beat morphology. Group 1 had ventricular premature beat QRS complexes with a smooth contour or with narrow (less than 40 msec) notching. Group 2 had ventricular premature beats with broad (greater than 40 msec) notching or shelves. All of these patients had normal or borderline normal ECGs and normal multiple-gated acquisition (MUGA) scans. Nine patients had type 1 ventricular premature beats, 20 patients had type II ventricular premature beats, and eight patients had both type I and type II ventricular premature beats. We conclude that the presence of group 2 ventricular premature beats is so frequent in patients with normal left ventricular ejection fractions that the use of this marker in identifying abnormal left ventricular function is suspect.
Angeles
K
K
Department of Cardiology, Methodist Hospital, Brooklyn, NY 11215.
Betzu
R
R
Gould
L A
LA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005117:Cardiac Complexes, Premature / Q000145:classification / Q000175:diagnosis* / Q000503:physiopathology; D009202:Cardiomyopathies / Q000175:diagnosis*; D003937:Diagnosis, Differential; D004562:Electrocardiography; D015716:Electrocardiography, Ambulatory; D005080:Exercise Test; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011877:Radionuclide Imaging; D013318:Stroke Volume