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Tytuł:
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Utility of Circadian Variability Patterns in Differentiating Origins of Premature Ventricular Complexes.
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Autorzy:
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Chen M; Department of Cardiology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Wang Q; Department of Cardiology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Sun J; Department of Cardiology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Zhang PP; Department of Cardiology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Li W; Department of Cardiology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Zhang R; Department of Cardiology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Mo BF; Department of Cardiology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Chen TZ; Department of Cardiology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Wan J; Department of Cardiothoracic Surgery, Affiliated Hospital of Southwest Medical University, Luzhou, China.
Xu DZ; Cardiovascular Division, Institute of Clinical Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
Aonuma K; Cardiovascular Division, Institute of Clinical Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
Li YG; Department of Cardiology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
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Źródło:
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Journal of interventional cardiology [J Interv Cardiol] 2020 Oct 30; Vol. 2020, pp. 7417912. Date of Electronic Publication: 2020 Oct 30 (Print Publication: 2020).
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Typ publikacji:
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Journal Article
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Język:
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English
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Imprint Name(s):
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Publication: 2019- : Hoboken, N.J. : Mumbai : Wiley ; Hindawi
Original Publication: [Mount Kisco, N.Y.] : Futura Pub. Co., [c1988-
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MeSH Terms:
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Ventricular Premature Complexes*/diagnosis
Ventricular Premature Complexes*/physiopathology
Ventricular Premature Complexes*/surgery
Catheter Ablation/*methods
Circadian Rhythm/*physiology
Electrocardiography, Ambulatory/*methods
Female ; Heart Rate ; Heart Ventricles/physiopathology ; Humans ; Male ; Middle Aged ; Patient Care Planning ; Retrospective Studies
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References:
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Entry Date(s):
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Date Created: 20201112 Date Completed: 20210409 Latest Revision: 20220418
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Update Code:
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20240105
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PubMed Central ID:
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PMC7647775
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DOI:
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10.1155/2020/7417912
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PMID:
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33177963
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Background: Premature ventricular complexes (PVCs) exhibit circadian fluctuation. We determine if PVCs of different origin exhibit specific circadian patterns.
Methods: We analyzed Holter recordings from patients with monomorphic PVCs who underwent catheter ablation. PVC circadian patterns were classified as fast-heart rate- (HR-) dependent (F-PVC), slow-HR-dependent (S-PVC), or HR-independent (I-PVC). PVC origins were determined intraprocedurally.
Results: In a retrospective cohort of 407 patients, F-PVC and S-PVC typically exhibited diurnal and nocturnal predominance, respectively. Despite decreased circadian fluctuation, I-PVC generally had heavier nocturnal than diurnal burden. PVCs of left anterior fascicle origin were predominantly S-PVC, while those of posterior hemibranch origin were mostly F-PVC. PVCs originating from the aortic sinus of Valsalva (ASV) were predominantly I-PVC, while most PVCs arising from the left ventricular outflow tract (LVOT) were F-PVC. Using a diurnal/nocturnal PVC burden ratio of 0.92 as the cutoff value to distinguish LVOT from ASV origin achieved 97% sensitivity and, as further verification, an accuracy of 89% (16/18) in a prospective cohort of patients with PVCs originating from either ASV or LVOT. In contrast, PVCs originating from right ventricles, such as right ventricular outflow tract, did not show distinct circadian patterns.
Conclusions: The circadian patterns exhibit origin specificity for PVCs arising from left ventricles. An analysis of Holter monitoring provides useful information on PVC localization in ablation procedure planning.
Competing Interests: The authors declare that there are no conflicts of interest.
(Copyright © 2020 Mu Chen et al.)
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