title: Premature ventricular contraction variability in arrhythmogenic right ventricular dysplasia/cardiomyopathy.
abstract: BACKGROUND
  Arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C) is an inherited cardiomyopathy, characterized by right ventricular dysfunction and ventricular arrhythmias. Premature ventricular contractions (PVCs) are an important measure in determining disease severity and constitute a minor criterion in the 2010 Task Force Criteria for the diagnosis of ARVD/C. Little information is available regarding the variability in PVCs.
  
  
  RESULTS
  Patients (n = 40) from the Johns Hopkins ARVD/C registry, meeting diagnostic criteria were included. Single lead continuous 12-lead electrocardiogram (ECG) monitors (Zio® Patches) were applied to monitor PVC counts. Detailed demographic, phenotypic, and structural information were obtained from registry data. ECG monitors were worn for a mean period of 159.3 hours (±39.3). Average 24-hour PVC count in this population was 1,090.5 (interquartile range = 1,711). One-way analysis of variance demonstrated statistically significant interday variance in mean hourly PVC counts in 76% of ARVD/C-positive subjects (28/37, 3 cases excluded due to insufficient data). Eleven individuals (27.5%) had maximum 24-hour PVC counts of >500 with a corresponding minimum 24-hour PVC count of <500. The average 24-hour PVC count for each patient was derived for each day recorded. The 24-hour PVC count placed 89.6% of counts (223/249) on the correct side of the 500-PVC count.
  
  
  CONCLUSIONS
  Statistically significant variation between 24-hour PVC counts is present in the ARVD/C population. However, 24-hour ECG monitoring was sufficient to identify 89.6% of 24-hour periods to the correct grouping based on 2010 Task Force Criteria.
authors.affiliation: Trauma Emergency and Acute Medicine Division, Kings College Hospital, London, UK.
authors.forename: Christian F
authors.initials: CF
authors.lastname: Camm
authors.forename: Crystal
authors.initials: C
authors.lastname: Tichnell
authors.forename: Cynthia A
authors.initials: CA
authors.lastname: James
authors.forename: Brittney
authors.initials: B
authors.lastname: Murray
authors.forename: Florence
authors.initials: F
authors.lastname: Porterfield
authors.forename: Anneline S J M
authors.initials: AS
authors.lastname: Te Riele
authors.forename: Harikrishna
authors.initials: H
authors.lastname: Tandri
authors.forename: Hugh
authors.initials: H
authors.lastname: Calkins
mesh_terms: D000200:Action Potentials; D000328:Adult; D000368:Aged; D019571:Arrhythmogenic Right Ventricular Dysplasia / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D015142:Baltimore; D015716:Electrocardiography, Ambulatory; D005260:Female; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012042:Registries; D012307:Risk Factors; D013997:Time Factors; D016278:Ventricular Function, Right; D018879:Ventricular Premature Complexes / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology
keywords: Holter; arrhythmogenic right ventricular dysplasia/cardiomyopathy; premature ventricular contractions; variability