Premature ventricular contraction variability in arrhythmogenic right ventricular dysplasia/cardiomyopathy

J Cardiovasc Electrophysiol. 2015 Jan;26(1):53-7. doi: 10.1111/jce.12544. Epub 2014 Oct 27.


Introduction: Arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C) is an inherited cardiomyopathy, characterized by right ventricular dysfunction and ventricular arrhythmias. Premature ventricular contractions (PVCs) are an important measure in determining disease severity and constitute a minor criterion in the 2010 Task Force Criteria for the diagnosis of ARVD/C. Little information is available regarding the variability in PVCs.

Methods and results: Patients (n = 40) from the Johns Hopkins ARVD/C registry, meeting diagnostic criteria were included. Single lead continuous 12-lead electrocardiogram (ECG) monitors (Zio® Patches) were applied to monitor PVC counts. Detailed demographic, phenotypic, and structural information were obtained from registry data. ECG monitors were worn for a mean period of 159.3 hours (±39.3). Average 24-hour PVC count in this population was 1,090.5 (interquartile range = 1,711). One-way analysis of variance demonstrated statistically significant interday variance in mean hourly PVC counts in 76% of ARVD/C-positive subjects (28/37, 3 cases excluded due to insufficient data). Eleven individuals (27.5%) had maximum 24-hour PVC counts of >500 with a corresponding minimum 24-hour PVC count of <500. The average 24-hour PVC count for each patient was derived for each day recorded. The 24-hour PVC count placed 89.6% of counts (223/249) on the correct side of the 500-PVC count.

Conclusion: Statistically significant variation between 24-hour PVC counts is present in the ARVD/C population. However, 24-hour ECG monitoring was sufficient to identify 89.6% of 24-hour periods to the correct grouping based on 2010 Task Force Criteria.

Keywords: Holter; arrhythmogenic right ventricular dysplasia/cardiomyopathy; premature ventricular contractions; variability.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Action Potentials
  • Adult
  • Aged
  • Arrhythmogenic Right Ventricular Dysplasia / complications*
  • Arrhythmogenic Right Ventricular Dysplasia / diagnosis
  • Arrhythmogenic Right Ventricular Dysplasia / physiopathology
  • Baltimore
  • Electrocardiography, Ambulatory
  • Female
  • Heart Rate*
  • Humans
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Registries
  • Risk Factors
  • Time Factors
  • Ventricular Function, Right
  • Ventricular Premature Complexes / diagnosis
  • Ventricular Premature Complexes / etiology*
  • Ventricular Premature Complexes / physiopathology