Abstract：
BACKGROUND: Premature ventricular contraction (PVC) burden is a risk factor for heart failure and cardiovascular death in patients with structural heart disease. Long-term electrocardiographic monitoring can have a significant impact on PVC burden evaluation by further defining PVC distribution patterns.
OBJECTIVE: This study aimed to ascertain the optimal duration of electrocardiographic monitoring to characterize PVC burden and to understand clinical characteristics associated with frequent PVCs and nonsustained ventricular tachycardia in a large US cohort.
METHODS: Commercial data (iRhythm\'s Zio patch) from June 2011 to April 2022 were analyzed. Inclusion criteria were age >18 years, PVC burden ≥5%, and wear period ≥13 days. PVC burden cutoffs were determined on the basis of AHA/ACC/HRS guidelines for very frequent PVCs (10,000-20,000 during 24 hours). Patients were assigned to categories by PVC densities: low, <10%; moderate, 10% to <20%; and high, ≥20%. Mean measured error was assessed at baseline and daily until the wear period\'s end for overall PVC burden and different PVC densities.
RESULTS: Analysis of 106,705 patch monitors revealed a study population with mean age of 70.6 ± 14.6 years (33.6% female). PVC burden was higher in male patients and those >65 years of age. PVC burden mean error decreased from 2.9% at 24 hours to 1.3% at 7 days and 0.7% at 10 days. Number of ventricular tachycardia episodes per patient increased with increasing PVC burden (P < .0001).
CONCLUSIONS: Extending ambulatory monitoring beyond 24 hours to 7 days or more improves accuracy of assessing PVC burden. Ventricular tachycardia frequency and duration vary by initial PVC density, highlighting the need for prolonged cardiac monitoring.
OBJECTIVE: This study aimed to ascertain the optimal duration of electrocardiographic monitoring to characterize PVC burden and to understand clinical characteristics associated with frequent PVCs and nonsustained ventricular tachycardia in a large US cohort.
METHODS: Commercial data (iRhythm\'s Zio patch) from June 2011 to April 2022 were analyzed. Inclusion criteria were age >18 years, PVC burden ≥5%, and wear period ≥13 days. PVC burden cutoffs were determined on the basis of AHA/ACC/HRS guidelines for very frequent PVCs (10,000-20,000 during 24 hours). Patients were assigned to categories by PVC densities: low, <10%; moderate, 10% to <20%; and high, ≥20%. Mean measured error was assessed at baseline and daily until the wear period\'s end for overall PVC burden and different PVC densities.
RESULTS: Analysis of 106,705 patch monitors revealed a study population with mean age of 70.6 ± 14.6 years (33.6% female). PVC burden was higher in male patients and those >65 years of age. PVC burden mean error decreased from 2.9% at 24 hours to 1.3% at 7 days and 0.7% at 10 days. Number of ventricular tachycardia episodes per patient increased with increasing PVC burden (P < .0001).
CONCLUSIONS: Extending ambulatory monitoring beyond 24 hours to 7 days or more improves accuracy of assessing PVC burden. Ventricular tachycardia frequency and duration vary by initial PVC density, highlighting the need for prolonged cardiac monitoring.
摘要：
背景：室性早搏（PVC）负担是结构性心脏病患者心力衰竭和心血管死亡的危险因素。通过进一步定义PVC分布模式，长期ECG监测可以对PVC负担评估产生重大影响。
目的：本研究旨在确定ECG监测的最佳持续时间，以表征PVC负荷，并了解美国大型队列中与频繁PVC和NSVT相关的临床特征。
方法：分析了2011年6月至2022年4月的商业数据（iRhythm的Zio贴片）。纳入标准为年龄>18岁，PVC负荷≥5%,磨损时间≥13天。基于用于非常频繁的PVC(在24小时内10,000-20,000)的AHA/ACC/HRS指南确定PVC负载截止值。患者按PVC密度分类：低（<10％），中度（10%至<20%）和高度（≥20%）。在基线和每日对总PVC负荷和不同PVC密度进行平均测量误差评估,直至磨损期结束。
结果：对106,705个贴片监测仪的分析显示，研究人群的平均年龄为70.6±14.6岁；33.6%为女性。男性和>65岁的男性PVC负担较高。PVC负荷平均误差从24小时的2.9%下降到7天的1.3%，和10天的0.7%。每位患者的VT发作次数随着PVC负担的增加而增加(p<0.0001)。
结论：将动态监测从24小时延长到7天或更长时间，提高评估PVC负荷的准确性。VT频率和持续时间因初始PVC密度而异，强调需要长期的心脏监测。
目的：本研究旨在确定ECG监测的最佳持续时间，以表征PVC负荷，并了解美国大型队列中与频繁PVC和NSVT相关的临床特征。
方法：分析了2011年6月至2022年4月的商业数据（iRhythm的Zio贴片）。纳入标准为年龄>18岁，PVC负荷≥5%,磨损时间≥13天。基于用于非常频繁的PVC(在24小时内10,000-20,000)的AHA/ACC/HRS指南确定PVC负载截止值。患者按PVC密度分类：低（<10％），中度（10%至<20%）和高度（≥20%）。在基线和每日对总PVC负荷和不同PVC密度进行平均测量误差评估,直至磨损期结束。
结果：对106,705个贴片监测仪的分析显示，研究人群的平均年龄为70.6±14.6岁；33.6%为女性。男性和>65岁的男性PVC负担较高。PVC负荷平均误差从24小时的2.9%下降到7天的1.3%，和10天的0.7%。每位患者的VT发作次数随着PVC负担的增加而增加(p<0.0001)。
结论：将动态监测从24小时延长到7天或更长时间，提高评估PVC负荷的准确性。VT频率和持续时间因初始PVC密度而异，强调需要长期的心脏监测。
