Association between ventricular arrhythmia (premature ventricular contractions burden and nonsustained ventricular tachycardia) and cardiovascular events in patients without structural heart disease

Background

Premature ventricular contractions (PVCs) and nonsustained ventricular tachycardia (NSVT) are common arrhythmias in cardiovascular clinical settings. However, the clinical significance of PVCs and NSVT in the absence of structural heart disease has not yet been fully elucidated. This study aimed to evaluate the association between PVCs, NSVT, and clinical outcomes.

Methods

A study population of 26,117 patients was drawn from the Shinken Database established in June 2004. We enrolled 6332 patients without structural heart disease who underwent 24-h Holter monitoring and were registered up to March 2019. We focused on ventricular arrhythmias and cardiovascular events in patients without structural heart diseases. The study population was divided by the number of baseline PVCs (PVCs: <1000 (n = 5507), 1000–9999 (n = 531), and 10 000 ≤(n = 294)). The study population was also divided according to the presence or absence of NSVT (n = 454 and n = 5878, respectively).

Result

During the follow-up period up to 3 years, there were 16 deaths, 24 heart failure-related hospitalizations, 14 acute coronary syndromes, and 37 embolism events. The frequency of PVCs was not associated with mortality or heart failure. On the other hand, the presence of NSVT was significantly associated with heart failure hospitalization in a multivariate model (hazard ratio: 3.02; 95% CI: 1.03–8.83; p = .044).

Conclusion

In patients without structural heart disease, NSVT was associated with a higher risk of heart failure hospitalization. Patients with NSVT but no structural heart diseases require careful follow-up and management of heart failure risk factors.