%0 Journal Article
%T Premature ventricular complexes: Assessing burden density in a large national cohort to better define optimal ECG monitoring duration.
%A Krumerman A
%A Di Biase L
%A Gerstenfeld E
%A Dickfeld T
%A Verma N
%A Liberman L
%A Amara R
%A Kacorri A
%A Crosson L
%A Wilk A
%A Ferrick KJ
%J Heart Rhythm
%V 21
%N 8
%D 2024 Aug 18
%M 38641221
%F 6.779
%R 10.1016/j.hrthm.2024.04.066
%X <B>BACKGROUND: </B>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.<BR><B>OBJECTIVE: </B>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.<BR><B>METHODS: </B>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.<BR><B>RESULTS: </B>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).<BR><B>CONCLUSIONS: </B>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.