Electrophysiology - Dependency of premature ventricular contractions on heart rate

To identify a method for characterizing the dynamic behavior of ventricular arrhythmias at different heart rates, 201 consecutive patients with frequent premature ventricular contractions (PVCs) underwent two 24-hour electrocardiographic monitoring periods. The percentage of PVCs for each cycle length was calculated and then analyzed by linear regression analysis. On the basis of the significance of the p value, and the positive or negative value of the slope, we identified three trends: a tachycardia-enhanced pattern (p < 0.01, slope negative), a bradycardia-enhanced pattern (p < 0.01, slope positive), and an indifferent pattern (p > 0.01). During the first monitoring period, a tachycardia-enhanced pattern was present in 56 patients (28%), a bradycardia-enhanced pattern was present in 49 patients (24%), and an indifferent pattern was present in 96 patients (48%). This relationship was reproducible in 41 of the patients with a tachycardia-enhanced pattern (73%), in 29 of the patients with a bradycardia-enhanced pattern (59%), and in 70 patients with an indifferent pattern (72%). In conclusion, it is possible to identify a spontaneous trend between the incidence of ventricular arrhythmias and the length of the preceding cardiac cycle that seems to remain stable over time.