Prevalence of frequent premature ventricular contractions and left-ventricular systolic dysfunction in patients receiving Holter monitoring.

BACKGROUND

Premature ventricular contractions (PVCs) are frequently observed with left ventricular (LV) systolic dysfunction, although the prevalence of these associated conditions in the general population remains unknown.

OBJECTIVE

We sought to understand the prevalence of frequent PVCs (defined PVCs > 5%) and high burden PVCs (defined PVCs > 10%) and LV systolic dysfunction in patients receiving ambulatory Holter monitors (HM).

METHODS

A prospective multicenter (eight US medical centers) cross-sectional study collected demographic and PVC burden data from consecutive patients undergoing 24-h, 48-h, and 14-day HM (July 2018-June 2020). Left ventricle ejection fraction (LVEF) data was collected if obtained within 6 months of HM. Four PVC burden groups were analyzed (<1%, 1%-5%, 5.1%-10%, and >10% burden) and stratified by normal LVEF (≥50%) or presence LVEF < 50%.

RESULTS

The prevalence of PVC burden of 5.1%-10% and >10% was 4% and 5%, respectively in the population undergoing HM (n = 6529). Age was significantly different between PVC groups (p < .001). In those with LVEF assessment (n = 3713), the prevalence of LVEF < 50% and both LVEF < 50% and PVC > 5% was 16.4% and 4.2%, respectively. The prevalence of PVC > 5% and PVC > 10% in patients with LVEF < 50% was 26% and 16%, respectively. PVC > 5% were more prevalent in older, male, and Caucasians (p < .001). Females had a lower prevalence of PVC > 5% than males (6% vs. 11%; p < .001), but not among those with LVEF < 50% (24% vs. 26%, p = .10).

CONCLUSION

PVC > 5% and PVC > 10% and LVEF < 50% are prevalent in patients undergoing HM. PVC > 5% are associated with older age. Females have a lower prevalence of PVC > 5% than males but similar combined PVC > 5% and LVEF < 50%.

CLINICALTRIAL: gov identifier: NCT03228823.