title: Patterns of ectopy leading to increased risk of fatal or near-fatal cardiac arrhythmia in patients with depressed left ventricular function after an acute myocardial infarction.
abstract: OBJECTIVE
  To identify potential new markers for assessing the risk of sudden arrhythmic events based on a method that captures features of premature ventricular complexes (PVCs) in relation to sinus RR intervals in Holter recordings (heartprint).
  
  
  RESULTS
  Holter recordings obtained 6 weeks after acute myocardial infarction from 227 patients with reduced ventricular function (left ventricular ejection fraction ≤ 40%) were used to produce heartprints. Measured indices were: PVCs per hour, standard deviation of coupling interval (SDCI), and the number of occurrences of the most prevalent form of PVCs (SNIB). Predictive values, survival analysis, and Cox regression with adjustment for clinical variables were performed based on primary endpoint, defined as an electrocardiogram-documented fatal or near-fatal arrhythmic event, death from any cause, and cardiac death. High ectopy (PVCs per hour ≥10) was a predictor of all endpoints. Repeating forms of PVCs (SNIB ≥ 83) was a predictor of primary endpoint, hazard ratio = 3.5 (1.3-9.5), and all-cause death, hazard ratio = 2.8 (1.1-7.3), but not cardiac death. SDCI ≤ 80 ms was a predictor of all-cause death and cardiac death, but not of primary endpoint.
  
  
  CONCLUSIONS
  High ectopy, prevalence of repeating forms of PVCs, and low coupling interval variability are potentially useful risk markers of fatal or near-fatal arrhythmias after myocardial infarction.
authors: Departamento de Instrumentacion Electromecanica, Instituto Nacional de Cardiologia Ignacio Chavez, Mexico, DF, Mexico 14080.
authors: Claudia
authors: C
authors: Lerma
authors: Alexander
authors: A
authors: Gorelick
authors: Raja N
authors: RN
authors: Ghanem
authors: Leon
authors: L
authors: Glass
authors: Heikki V
authors: HV
authors: Huikuri
mesh_terms: D000368:Aged; D015897:Comorbidity; D015716:Electrocardiography, Ambulatory / Q000706:statistics & numerical data*; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000401:mortality*; D015995:Prevalence; D011379:Prognosis; D015203:Reproducibility of Results; D012307:Risk Factors; D012680:Sensitivity and Specificity; D016019:Survival Analysis; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis* / Q000401:mortality*; D018879:Ventricular Premature Complexes / Q000175:diagnosis* / Q000401:mortality*
keywords: Holter monitoring; Implantable cardioverter-defibrillator; Myocardial infarction; Premature ventricular beats; Sudden arrhythmic event