title: Diagnosis and management of premature ventricular complexes-associated chronic cough.
abstract: BACKGROUND
  Chronic cough frequently remains unexplained. Although various cardiac arrhythmias have already been reported as a cause of chronic cough, this phenomenon has not been evaluated prospectively. Therefore, we studied the incidence and management of cough associated with premature ventricular complexes (PVCs) in a population of patients with this condition.
  
  
  METHODS
  Patients without organic heart disease who had been referred for the management of symptomatic PVC were evaluated prospectively. PVC-associated cough was recognized if cough episodes occurred just after spontaneous or induced PVC or observed in an ECG or a multichannel recording system that included ECG. A differential diagnosis of cough was performed according to the guidelines on cough. Afterward, antiarrhythmic therapy was instituted to eliminate PVC and cough.
  
  
  RESULTS
  Of the 120 patients who were referred for the management of PVC, 10 had a chronic cough. After extensive workup for the cause of chronic cough, the cough was thought to be solely due to PVC in one patient, partially due to PVC plus another cause in five patients, and not due to PVC but to nonasthmatic eosinophilic bronchitis, gastroesophageal reflux disease, and chronic sinusitis in four patients. Patients with PVC-associated cough reported more severe perception of symptoms associated with arrhythmia than patients without cough (mean [+/- SD] visual analog scale score, 8.2 +/- 0.5 vs 5.7 +/- 1.6, respectively; p < 0.01). PVC-associated cough disappeared after antiarrhythmic treatment (radiofrequency ablation [n = 4], oral antiarrhythmic agent [n = 1]), or after spontaneous remission of PVC (n = 1).
  
  
  CONCLUSIONS
  PVC may be a cause of chronic cough. Interdisciplinary cooperation is warranted for the proper diagnosis and management of PVC-associated cough.
authors.affiliation: Department of Cardiology, Grochowski Hospital, Postgraduate Medical School, Warsaw, Poland. Electronic address: smstec@wp.pl.
authors.forename: Sebastian M
authors.initials: SM
authors.lastname: Stec
authors.affiliation: Department of Internal Medicine, Pneumonology and Allergology, Warsaw Medical University, Warsaw, Poland.
authors.forename: Elżbieta M
authors.initials: EM
authors.lastname: Grabczak
authors.affiliation: Department of Internal Medicine, Pneumonology and Allergology, Warsaw Medical University, Warsaw, Poland.
authors.forename: Piotr
authors.initials: P
authors.lastname: Bielicki
authors.affiliation: Department of Cardiology, Grochowski Hospital, Postgraduate Medical School, Warsaw, Poland.
authors.forename: Beata
authors.initials: B
authors.lastname: Zaborska
authors.affiliation: Department of Internal Medicine, Pneumonology and Allergology, Warsaw Medical University, Warsaw, Poland.
authors.forename: Rafał
authors.initials: R
authors.lastname: Krenke
authors.affiliation: Department of Cardiology, Grochowski Hospital, Postgraduate Medical School, Warsaw, Poland.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Kryński
authors.affiliation: Department of Internal Medicine, Pneumonology and Allergology, Warsaw Medical University, Warsaw, Poland.
authors.forename: Marta
authors.initials: M
authors.lastname: Dąbrowska
authors.affiliation: Department of Internal Medicine, Pneumonology and Allergology, Warsaw Medical University, Warsaw, Poland.
authors.forename: Joanna
authors.initials: J
authors.lastname: Domagała-Kulawik
authors.affiliation: Department of Otolaryngology, Warsaw Medical University, Warsaw, Poland.
authors.forename: Anna
authors.initials: A
authors.lastname: Domeracka-Kołodziej
authors.affiliation: Department of Cardiology, Grochowski Hospital, Postgraduate Medical School, Warsaw, Poland.
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Sikorska
authors.affiliation: Department of Cardiology, Grochowski Hospital, Postgraduate Medical School, Warsaw, Poland.
authors.forename: Piotr
authors.initials: P
authors.lastname: Kułakowski
authors.affiliation: Department of Internal Medicine, Pneumonology and Allergology, Warsaw Medical University, Warsaw, Poland.
authors.forename: Ryszarda
authors.initials: R
authors.lastname: Chazan