The full content of Annals is available to subscribers

Subscribe/Learn More  >
Original Research |

Prognostic Implications of Asymptomatic Ventricular Arrhythmias: The Framingham Heart Study

Mahesh Bikkina, MD, MPH; Martin G. Larson, ScD; and Daniel Levy, MD
[+] Article, Author, and Disclosure Information

Grant Support: In part by an educational grant from Parke-Davis (Dr. Bikkina).

Requests for Reprints: Daniel Levy, MD, Framingham Heart Study, 5 Thurber Street, Framingham, MA 01701.

Current Author Addresses: Dr. Bikkina: University of South Alabama, Department of Cardiology, 2451 Fillingim Street, Tenth Floor, Mobile, AL 36617.

Drs. Larson and Levy: Framingham Heart Study, 5 Thurber Street, Framingham, MA 01701.

Ann Intern Med. 1992;117(12):990-996. doi:10.7326/0003-4819-117-12-990
Text Size: A A A

Objective: To evaluate the prevalence and prognostic significance of asymptomatic complex or frequent ventricular premature beats detected during ambulatory electrocardiographic (ECG) monitoring.

Design: Cohort study with a follow-up period of 4 to 6 years.

Setting: Population-based.

Participants: Surviving patients of the original Framingham Heart Study cohort and offspring of original cohort members (2727 men and 3306 women).

Measurements: One-hour ambulatory electrocardiography.

Results: The age-adjusted prevalence of complex or frequent arrhythmia (more than 30 ventricular premature complexes per hour or multiform premature complexes, ventricular couplets, ventricular tachycardia, or R-on-T ventricular premature complexes) was 12% (95% Cl, 11 % to 13%) in the 2425 men without clinically evident coronary heart disease and 33% (Cl, 24% to 42%) in the 302 men with coronary heart disease. The corresponding values in women (3064 without disease and 242 with disease) were 12% (Cl, 11% to 13%) and 26% (Cl, 9% to 43%). After adjusting for age and traditional risk factors for coronary heart disease in a Cox proportional hazards model, men without coronary heart disease who had complex or frequent ventricular arrhythmias were at increased risk for both all-cause mortality (relative risk, 2.30; Cl, 1.65 to 3.20) and the occurrence of myocardial infarction or death from coronary heart disease (relative risk, 2.12; Cl, 1.33 to 3.38). In men with coronary heart disease and in women with and without coronary heart disease, complex or frequent arrhythmias were not associated with an increased risk for either outcome.

Conclusions: In men who do not have clinically apparent coronary heart disease, the incidental detection of ventricular arrhythmias is associated with a twofold increase in the risk for all-cause mortality and myocardial infarction or death due to coronary heart disease. The preventive and therapeutic implications of these findings await further investigation.





Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).


Submit a Comment/Letter
Submit a Comment/Letter

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.


Buy Now for $42.00

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Related Articles
Related Point of Care
Topic Collections
PubMed Articles
Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.