Premature ventricular complexes: therapeutic dilemmas and decisions

Advances in Cardiology
D W SnyderB E Sobel

Abstract

Adult subjects with high-grade VEA have an increased risk of sudden death. In all likelihood, the risk reflects a predisposition to VF with concomitant but possibly independently caused VEA. Among patients sustaining acute myocardial infarction, the severity of VEA late after infarction appears to depend primarily on the extent of underlying coronary artery disease and the extent of tissue damage sustained, as does the likelihood of sudden death. It is not yet clear whether suppression of one manifestation of severe coronary artery disease, namely VEA, confers protection against more serious manifestations - particularly sudden death. Although increased mortality among patients with and without overt coronary artery disease is associated with high-grade VEA and although the absolute frequency of PVCs is strongly correlated with severity defined with conventional classification schemes, frequent, unifocal PVCs in the absence of high-grade VEA appear to carry only a small associated risk of sudden death [56]. Furthermore, even though early PVCs may be particularly hazardous soon after the onset of acute myocardial infarction, they do not appear to be malignant during the hospital phase or among ambulatory patients with or without...Continue Reading

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