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Ventricular Premature Beats: Difference between revisions
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The origin of the VPB can be derived from its form. A LBTB-configured VPB originates in the right ventricle. A RBTB-configured VPB comes from the left ventricle. The QRS duration of a VPB is > 0.12 seconds and can be as wide as 0.16-0.20 seconds. | The origin of the VPB can be derived from its form. A LBTB-configured VPB originates in the right ventricle. A RBTB-configured VPB comes from the left ventricle. The QRS duration of a VPB is > 0.12 seconds and can be as wide as 0.16-0.20 seconds. | ||
A sequence of three or more extrasystoles is called a [[ | A sequence of three or more extrasystoles is called a [[Ventricular Tachycardia|non-sustained ventricular tachycardia]]. | ||
If more than one VPB is present on the ECG, they can be: | If more than one VPB is present on the ECG, they can be: | ||
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*'''trigemini''': every second sinus beat is follow by a ventricular extrasystole. | *'''trigemini''': every second sinus beat is follow by a ventricular extrasystole. | ||
VPBs are associated with numerous cardiac diseases (e.g. structural heart disease, ischemia, congenital arrhythmias, pulmonary disease). | |||
However, VPBs are also relatively common in patients without known heart disease. The importance of VPBs for prognosis is controversial. A study by Abdalla et. al <cite>Abdalla</cite> followed 15.637 apparantly healty men aged 35 to 57 years. The prevalence of VPBs was 4.4%. In a subgroup of patients with frequent (2 or more uniform VPCs every 2 minutes) and complex VPBs (multiforms, pairs, runs, R-on-T) the risk of sudden cardiac death was 4.2. In the Framingham study 12% of men and 33% of women without clinically evident coronary heart disease had frequent (>30 VPBs per hour) or complex VPBs. In men, this was associated with a two fold increase of death. However, in another study asymptomatic patients had a good prognosis. <cite>Kennedy</cite> In conclusion sporadic VPBs are relatively benign and frequent and complex VPBs are reason for further examination. | |||
==References=== | |||
<biblio> | |||
#Kennedy pmid=2578212 | |||
#Framingham pmid=1280018 | |||
#Abdalla pmid=3673904 | |||
</biblio> | |||
{{clr}} | {{clr}} | ||