Ventricular Premature Beats and Mortality after Myocardial Infarction

TLDR

The study evaluated whether ventricular premature beats predict mortality in 1,739 men with prior myocardial infarction by monitoring ectopic activity for one hour at baseline and following them for up to four years. Ectopic activity was recorded for one hour during a standard baseline examination, and patients were followed for mortality over an average of 24.4 months. Complex ventricular premature beats were associated with a threefold increase in sudden coronary death and a twofold increase in all‑cause mortality, independently elevating risk throughout the follow‑up. Published in N Engl J Med 297:750–757, 1977.

Abstract

To assess the role of ventricular premature beats in influencing mortality of coronary patients, 1739 men with prior myocardial infarction were monitored for ectopic activity for one hour at a standard base-line examination, and followed for mortality for periods up to four years (average, 24.4 months). Analyses of survival taking into account other important prognostic variables establish that the presence of complex premature beats (R on T, runs of 2 or more, multiform or bigeminal premature beats) in the monitoring hour is associated with a risk of sudden coronary death three times that of the men free of complex ventricular premature beats. The corresponding risk of death from any cause is twice that of men without such complex beats in the hour. These arrhythmias make an independent contribution to increased risk of death that persists over the length of this observation period. (N Engl J Med 297:750–757, 1977)