Clinical Follow-up Study Of Premature Ventricular Complexes

Ventricular premature beat is a kind of common arrhythmia in clinic,which refers to the ventricular depolarization caused by abnormal foci of excitation below Kent-His bundle and the branch.It was previously believed that the ventricular premature beat of non-structural heart diseases had low risk and good prognosis,but in recent years,it was found that long-term high load ventricular premature beat can lead to cardiomyopathy,malignant arrhythmia and even cardiac death.Studies found that the risk for patients without structural heart diseases and with ventricular premature beat frequency of equal to or less than 10,000 within 24 hours to die from cardiovascular event after 10 years is no higher than that for average person,however,for patients with ventricular premature beat frequency of equal to or higher than 10,000 within 24 hours or load capacity of above 10%,the cardiovascular mortality increases significantly.At present,it is deemed that ventricular premature beat with frequency of equal to or less than 10,000 within 24 hours in patients without structural heart diseases should be actively intervened,while studies on the effect of different treatment methods for ventricular premature beat frequency of less than 10,000 within 24 hours on the prognosis are few currently.ObjectiveTo evaluate the therapeutic effects of antiarrhythmic drug therapy,TCM treatment and follow-up observation on patients without structural heart diseases and with unisource ventricular premature beat frequency of less than 10,000 within 24 hours,and to explore the best therapeutic regimen for those patients.Method:The ventricular premature beat patients without structural heart diseases treated in the outpatient and inpatient department of our hospital from 2013 to 2015 were selected,the detailed inquiry of the medical history,physical examination,12 lead electrocardiogram examination and 24-hour dynamic electrocardiogram examination were performed on these patients successively.After analysis,patients without structural heart diseases and with unisource ventricular premature beat frequency of less than 10,000 within 24 hours were selected,and 160 cases of patients with multisource or pairing ventricular premature beat,non-sustained ventricular tachycardia,or R on T ventricular premature beat were excluded.These patients included were randomly divided into three groups,those are,the antiarrhythmic group(n=72),in which metoprolol,propafenone,amiodarone or sotalol was used for treatment;the Chinese medicine group(n=51),in which Shensongyangxin capsules or Wenxinganules was used for treatment;the control group(n=37),in which only regular follow-up visit was performed.All the patients included were performed routine echocardiographic examination before treatment to evaluate left ventricular end systolic diameter(LVESD),left ventricular end diastolic diameter(LVEDD),left ventricular ejection fraction(LVEF)and other parameters.The occurrence of ventricular premature beat within two years was observed;regular electrocardiogram examination and dynamic electrocardiogram examination were performed,outpatient follow-up and telephone follow-up were carried on for 2 years,and the occurrence of adverse events(death,hospitalization due to cardiovascular disease,ventricular tachycardia,heart failure)was recorded.SPSS19.0 software was used for analysis.The measurement data was represented by(`x±s),and single factor analysis of variance was used for comparison among groups using.The count data was represented by n(%),and chi-square analysis was used for comparison among groups.For comparison between any two groups,the significance level should be corrected,and significant level of p<0.05 represents the existence of statistical significance.Results1.The 160 cases of included patients were divided into antiarrhythmic drug group(n=72),Chinese medicine group(n=51)and control group(n=37).The difference in age,sex ratio,duration of symptoms,average heart rate,basic ventricular premature beat frequency,echocardiographic parameters and other clinical features between patients in the three groups had no statistical significance(P>0.05),and there is homogeneity between the three groups.2.After two-year follow-up visit,the difference in LVESD,LVEDD and LVEF of the echocardiography between patients in the three groups had no statistical significance(P>0.05),and all the included patients had no ventricular premature beat cardiomyopathy.3.After follow-up period,there was no significant difference in adverse events(death,hospitalization due to cardiovascular disease,ventricular tachycardia,heart failure)between the three groups(P>0.05).4.There was no significant difference in the reduce time of ventricular premature beat between the three groups(P>0.05).ConclusionFor patients without structural heart diseases and with unisource ventricular premature beat frequency of less than 10,000 within 24 hours,after antiarrhythmic drug therapy,TCM therapy and mere observation,it was found that there was no significant difference in the echocardiographic parameters,the occurrence rate of ventricular premature beat cardiomyopathy,the occurrence of adverse events and the reduce time of ventricular premature beat,so there is no need for long-term application of drug therapy in such patients.