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Longer Ambulatory ECG Monitoring Increases Identification of Clinically Significant Ectopy.

Publication ,  Journal Article
Loring, Z; Hanna, P; Pellegrini, CN
Published in: Pacing Clin Electrophysiol
June 2016

BACKGROUND: Frequent premature ventricular contractions (PVCs) can cause a reversible reduction in systolic function. Most studies use 24-hour ambulatory electrocardiograms (AECGs) to assess PVC burden; however, PVC counts vary across 24-hour periods. We hypothesized that extended AECG monitoring would better identify clinically significant ectopy. METHODS: All 14-day AECGs performed at the San Francisco Veterans Affairs Medical Center between 2012 and 2015 (N = 694) were reviewed, and individuals with PVC counts ≥1.0% of total heartbeats were included (N = 101). Daily PVC counts and the range of these values across 24-hour periods were assessed. Median time for these ranges to cross clinically significant thresholds (PVCs ≥ 10%, 15%, or 20% of total heartbeats) was determined. RESULTS: Median PVC burden was 2.6% of total heartbeats (interquartile range [IQR]: 1.6-5.4%) and the median range across 24-hour periods was 3.6% (IQR: 2.0-9.1%). Individual ranges of daily PVC burden crossed thresholds of 10%, 15%, and 20% of total heartbeats in 26.7%, 16.8%, and 6.9% of patients, respectively. Median time to detecting an individual's maximum PVC burden was 6 days (IQR: 2-11 days). While 75% of those who reached the 20% threshold did so on day one of monitoring, only 53% of those reaching the 10% threshold did similarly, with a continually increasing yield throughout the 14-day monitoring period. CONCLUSIONS: PVC burden varies widely from day-to-day. While most patients with PVC burdens ≥20% were detected with 24 hours of monitoring, extended monitoring nearly doubled the identification of those reaching the 10% threshold.

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Published In

Pacing Clin Electrophysiol

DOI

EISSN

1540-8159

Publication Date

June 2016

Volume

39

Issue

6

Start / End Page

592 / 597

Location

United States

Related Subject Headings

  • Ventricular Premature Complexes
  • Time Factors
  • Male
  • Humans
  • Female
  • Electrocardiography, Ambulatory
  • Cardiovascular System & Hematology
  • Aged
  • 3202 Clinical sciences
  • 3201 Cardiovascular medicine and haematology
 

Citation

APA
Chicago
ICMJE
MLA
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Loring, Z., Hanna, P., & Pellegrini, C. N. (2016). Longer Ambulatory ECG Monitoring Increases Identification of Clinically Significant Ectopy. Pacing Clin Electrophysiol, 39(6), 592–597. https://doi.org/10.1111/pace.12852
Loring, Zak, Peter Hanna, and Cara N. Pellegrini. “Longer Ambulatory ECG Monitoring Increases Identification of Clinically Significant Ectopy.Pacing Clin Electrophysiol 39, no. 6 (June 2016): 592–97. https://doi.org/10.1111/pace.12852.
Loring Z, Hanna P, Pellegrini CN. Longer Ambulatory ECG Monitoring Increases Identification of Clinically Significant Ectopy. Pacing Clin Electrophysiol. 2016 Jun;39(6):592–7.
Loring, Zak, et al. “Longer Ambulatory ECG Monitoring Increases Identification of Clinically Significant Ectopy.Pacing Clin Electrophysiol, vol. 39, no. 6, June 2016, pp. 592–97. Pubmed, doi:10.1111/pace.12852.
Loring Z, Hanna P, Pellegrini CN. Longer Ambulatory ECG Monitoring Increases Identification of Clinically Significant Ectopy. Pacing Clin Electrophysiol. 2016 Jun;39(6):592–597.

Published In

Pacing Clin Electrophysiol

DOI

EISSN

1540-8159

Publication Date

June 2016

Volume

39

Issue

6

Start / End Page

592 / 597

Location

United States

Related Subject Headings

  • Ventricular Premature Complexes
  • Time Factors
  • Male
  • Humans
  • Female
  • Electrocardiography, Ambulatory
  • Cardiovascular System & Hematology
  • Aged
  • 3202 Clinical sciences
  • 3201 Cardiovascular medicine and haematology