title: Characteristics of unselected high-burden premature ventricular contraction patients.
abstract: BACKGROUND
  High-burden premature ventricular contractions (PVCs) may be an important determinant of heart failure (HF) in patients presenting for PVC ablation. The prevalence and characteristics of high-burden PVC patients outside this setting remain unknown. We, therefore, sought to determine predictors of high-burden PVCs and, among high-burden PVC patients, predictors of HF.
  
  
  METHODS
  We identified all patients undergoing a 24-48-hour Holter study showing at least 20% PVCs between 2005 and 2013 at the University of California, San Francisco. Three time-matched controls undergoing Holter monitoring were selected for each high-burden PVC patient. Medical records were reviewed and test characteristics of PVC counts from 12-lead electrocardiograms (ECG) as predictors of high-burden PVC Holters were analyzed.
  
  
  RESULTS
  Among 5,091 participants, 66 (1.3%) exhibited at least 20% PVCs. After multivariate adjustment, high-burden PVC patients had a three-fold greater odds of HF (odds ratio [OR] 3.15; 95% confidence interval [CI] 1.28-6.50; P = 0.005) and 10-fold greater odds of having a first-degree family member with sudden death (OR 9.97; 95% CI 1.78-60.8; P = 0.011). The C-statistic for the number of PVCs on 12-lead electrocardiogram as a predictor of high-burden PVCs was 0.7949. Among high-burden PVC patients, HF was associated with a history of coronary artery bypass grafting (OR 11.76; 95% CI 1.30-106.49; P = 0.028).
  
  
  CONCLUSIONS
  Among all undergoing Holter monitoring, 1.3% exhibited high-burden PVCs, a phenomenon associated with HF and a first-degree family history of sudden death. In an analysis restricted to high-burden PVC patients, a history of coronary artery bypass grafting was a predictor of HF.
authors: Division of Cardiology, Electrophysiology Section, University of California, San Francisco, California.
authors: Jingkun
authors: J
authors: Yang
authors: Ramzi
authors: R
authors: Dudum
authors: Mala C
authors: MC
authors: Mandyam
authors: Gregory M
authors: GM
authors: Marcus
mesh_terms: D003430:Cross-Sectional Studies; D015716:Electrocardiography, Ambulatory; D005260:Female; D006333:Heart Failure / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D018879:Ventricular Premature Complexes / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology
keywords: Holter monitor; congestive heart failure; electrocardiogram; premature ventricular contractions; sudden death