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Title: Ventricular arrhythmias are not a short-term reproducible phenomenon - why long recording monitoring is necessary
Authors: Maia Reis, Maria do Carmo [UNIFESP]
Ferreira Silva, Nancy Christiane [UNIFESP]
Vincenzo de Paola, Angelo Amato [UNIFESP]
Luna Filho, Braulio [UNIFESP]
Universidade Federal de São Paulo (UNIFESP)
Keywords: Ventricular arrhythmia
Holter monitoring
Issue Date: 1-May-2014
Publisher: Churchill Livingstone Inc Medical Publishers
Citation: Journal of Electrocardiology. Philadelphia: Churchill Livingstone Inc Medical Publishers, v. 47, n. 3, p. 335-341, 2014.
Abstract: Background: the variability of ventricular arrhythmias (VA) among different days of the week is not well detected by one-day Holter monitoring.Aims: To evaluate whether there are differences in VA distribution pattern during long recording period.Methods: the EKG was recorded for 14 h per day during 7 days by Holter system in 34 consecutive pat ventricular couplets and non-sustained ventricular tachycardia (NSVT) recording from patients provided graphic data. We applied the Hurst method (H Coefficient) which evaluates whether a repetitive phenomenon is random or not. When the H is >0.5 and <1 means it is not random and implies a long-term memory effect. Considering the arrhythmic variability, the data were also analyzed by repetitive ANOVA comparing incidence of arrhythmias among the days.Results: Isolated PVCs and ventricular couplets during 98 h recording provided graphic of the occurrence. A trend of increasing and decreasing of arrhythmias was observed which looks erratic. the H coefficient, however, was significantly >0.5 for all patients. Repeated ANOVA showed statistic difference among days in 31 patients with isolated PVCs; in 26 with ventricular couplets and 19 with NSVT when analyzed per hour during week days (p < 0.05).Conclusion: PVCs, ventricular couplets and NSVT are not a random phenomenon. Our data suggest the occurrence of ventricular arrhythmias had no similarity among the days, making unlikely that a single Holter recording for 24 h may capture this phenomenon. (C) 2014 Elsevier Inc. All rights reserved.
ISSN: 0022-0736
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