Kanebraun2314

Background The clinical significance of premature ventricular complexes (PVCs) in heart failure (HF) remains unclear. We aimed to clarify the associations of PVC burden with re-hospitalization and cardiac death in HF patients. Methods We studied 435 HF patients (271 men, mean age 65 years). All patients were hospitalized for worsening HF. After optimal medications, echocardiography, 24 hours Holter monitoring and cardiopulmonary exercise testing were performed before discharge. The clinical characteristics and outcomes of the HF patients were investigated. Results During a median follow-up period of 2.3 years, there were 125 (28.7%) cardiac events (re-hospitalization due to worsening HF, fatal arrhythmias, or cardiac death). The patients with cardiac events had higher PVC burden compared to those without (median 0.374%/d [interquartile range 0.013-1.510] vs median 0.026%/d [interquartile range 0.000-0.534], P 0.145%/d, n = 194) compared to those with low-PVC burden (≤0.145%/d, n = 241). Furthermore, the high-PVC burden patients had left ventricular (LV) and atrial dilatation, reduced LV ejection fraction, and impaired exercise capacity, compared to the low-PVC burden patients. In Cox proportional hazards analysis, high-PVC burden was significantly associated with cardiac events with a hazard ratio of 2.028 (95% confidence interval 1.418-2.901, P  less then  .001). Conclusion These results suggest that PVC burden is an important predictor of cardiac events in HF patients. © 2019 The Authors. Journal of Arrhythmia published by John Wiley & Sons Australia, Ltd on behalf of the Japanese Heart Rhythm Society.Background We examined risk factors for development of ventricular tachycardia (VT) in pediatric patients with ventricular premature contractions (VPCs) and a structurally normal heart. Methods The subjects were 81 844 first graders and 88 244 seventh graders of Kagoshima City School-based cardiovascular screening (SCV-screening) between 2001 and 2015. We retrospectively reviewed the clinical data of students who were diagnosed as having VPC. Results Ventricular premature contractions were observed in 134 first graders (0.16%) and 270 seventh graders (0.31%). On the screening electrocardiograms (ECGs), 43 patients (11%) showed bi-/trigemini, three patients (0.7%) showed a couplet, and one patient showed VT. We obtained 166 patients' follow-up information and evaluated 59 patients (36%) as improved, 97 patients (58%) as no change, and 10 patients (6%) as worsened (couplets, five; triplets, two; VT, three). We assumed that these worsened patients have risk factors for development of VT. Comparing the findings of SCV-screening ECGs of risk patients with the others, a significant difference was observed only in the number of VPCs (per 10 seconds) (mean ± SD; 4.3 ± 2.6 vs 1.8 ± 1.4, P  less then  .0001). A logistic regression analysis revealed that the number of VPCs was significant (P  less then  .001, odds ratio; 2.01, 95% confidence intervals; 1.46-2.93). Receiver operating characteristics analysis showed an adequate cut-off number of three VPCs for the risk, the sensitivity was 89% and the specificity was 77%. Conclusions Of the patients with VPC and a structurally normal heart, a few patients developed VT. Careful observation is important in patients who had three or more VPCs on SCV-screening ECG. © 2019 The Authors. Journal of Arrhythmia published by John Wiley & Sons Australia, Ltd on behalf of Japanese Heart Rhythm Society.Background The prolongation of repolarization time between the myocardial epicardium and endocardial cells is closely related to malignant ventricular arrhythmias. The purpose of our study was to compare repolarization markers, namely, T-wave peak-end interval (Tp-e), QT, corrected QT (QTc), Tp-e/QT, Tp-e/corrected QT (QTc), and Heart Rate Variability (HRV) values in healthy men and women and to investigate their daily variations. Methods A total of 74 male and 78 female participants, being a government employee, and having no health problems, were included in the two study groups (males and females). Selleck SHP099 A 24-hour, 12-lead Holter monitoring was performed on the volunteers. Then, the Tp-e interval and QT interval were measured on recordings. cTp-e and QTc were calculated by the use of Bazzet's formula. Results There was no statistically significant difference between the groups in the cTp-e interval at 07.00 pm; however, it was significantly lower in the female group as compared with the male group at 07.00 am and 01.00 pm. It was significantly higher in the female group at 01.00 am compared with the male group. There were statistically significant moderate negative correlations between Tp-e intervals and a standard deviation of between two normal beats interval (SDNN) values at various hours of the same day. Conclusion There were statistically significant differences in terms of Tp-e and cTp-e intervals at various hours of the same day in both groups. In addition, there were statistically significant moderate negative correlations between Tp-e intervals and SDNN at various hours of the same day. © 2020 The Authors. Journal of Arrhythmia published by John Wiley & Sons Australia, Ltd on behalf of the Japanese Heart Rhythm Society.Background The risk stratification of coronary heart disease (CHD) and/or heart failure (HF) patients with easily measured electrocardiographic markers is of clinical importance. The aim of this meta-analysis is to indicate whether increased QT dispersion (QTd) is associated with fatal and nonfatal outcomes in patients with CHD and/or HF. Methods We systematically searched MEDLINE and Cochrane databases without restrictions until August 15, 2018 using the keyword "QT dispersion". Studies including data on the association between QTd and all-cause mortality, sudden cardiac death (SCD) or arrhythmic events in patients with HF and/or CHD were classified as eligible. Results In the analysis including patients with CHD and/or HF, we found that QTd did not differ significantly in patients with SCD compared to no SCD patients while QTd was significantly greater in the group of all-cause mortality patients and in patients who experienced a sustained ventricular arrhythmia. Subgroup analysis showed that in myocardial infarction studies, QTd was significantly higher in patients with an arrhythmic event compared to arrhythmic event-free patients while a nonsignificant difference was found in QTd in patients who died from any cause compared to survivors.