Division of Cardiology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 135-710, Republic of Korea
Division of Cardiology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 135-710, Republic of Korea.
Europace. 2016 Jun;18(6):881-7. doi: 10.1093/europace/euv112. Epub 2015 May 14.
Most patients with idiopathic ventricular premature depolarizations (VPDs) complain of symptoms related to this arrhythmia, but some patients are asymptomatic even with a high VPD burden. Our understanding of the relationship between symptoms and cardiomyopathy related to this arrhythmia remains limited.
We evaluated 801 subjects (381 men; mean age, 55 ± 17 years) who visited our outpatient clinic. All subjects were diagnosed with frequent VPDs (1% or >1000 beats/day). The patients were divided into two groups according to the presence or absence of typical VPD symptoms (palpitations or skipped beats during VPDs): symptomatic patients (n = 455) and asymptomatic patients (n = 346). Clinical and electrocardiogram parameters were compared between these two groups. In the symptomatic group, palpitations were the most frequent symptom (91%). Daily VPD burden (P = 0.90) and electrocardiogram parameters (P>0.05) did not differ significantly between groups. The incidence of frequent VPDs with left ventricular dysfunction was significantly higher in the asymptomatic group (symptomatic patients, 3.0%; asymptomatic patients, 10.5%; P < 0.001).
The absence of typical VPD-related symptoms may be a risk factor for cardiomyopathy and be associated with an adverse outcome.
大多数特发性室性期前收缩（VPD）患者会出现与该心律失常相关的症状，但也有一些患者即使 VPD 负荷较高也没有症状。我们对症状与与该心律失常相关的心肌病之间的关系的了解仍然有限。
我们评估了 801 名（381 名男性；平均年龄 55±17 岁）在我们门诊就诊的患者。所有患者均被诊断为频发 VPD（1%或>1000 次/天）。根据是否存在典型的 VPD 症状（VPD 期间出现心悸或漏搏），将患者分为两组：有症状患者（n=455）和无症状患者（n=346）。比较两组之间的临床和心电图参数。在有症状组中，心悸是最常见的症状（91%）。两组之间每日 VPD 负荷（P=0.90）和心电图参数（P>0.05）没有显著差异。无症状组频发 VPD 伴左心室功能障碍的发生率明显更高（有症状患者 3.0%；无症状患者 10.5%；P<0.001）。
缺乏典型的 VPD 相关症状可能是心肌病的一个危险因素，并与不良预后相关。
