Research Of Related Factors Affecting Clinical Symptoms In Patients With Frequent Premature Ventricular Contractions

BackgroundPremature ventricular contraction(PVC)is the most common clinical arrhythmia.It happens in patients with both normal hearts and organic heart diseases.For most of patients with frequent premature ventricular contractions(FPVCs),the treatment strategies depend on whether the patient has symptoms or not.However,little attention was paid on the clinical symptoms and its related factors in patients with FPVCs.ObjectiveTo determine the correlation between the symptoms and the PVCs,analyse the predictors of clinical symptoms in patients with FPVCs.MethodsClinical data of patients diagnosed as FPVCs in Xuzhou Central Hospital(The affiliated Xuzhou Hospital of Medical College of Southeast University)from 2017 June to 2017 December were collected.All the patients were synchronized with the symptoms and continuous ECG monitoring.According to the consistency of the symptoms and PVCs,the patients were divided into three groups: the asymptomatic group,the symptoms-PVCs relevant group(the real symptom group)and the symptoms-PVCs irrelevant group(the pseudosymptom group).The relevance between symptoms and PVCs were determined by grouping.Clinical data(including the general information,combined diseases,electrocardiogram,24-hour ambulatory monitoring,ultrasonic cardiogram,anxiety and sleep quality)between patients from each groups were compared to discuss the predictors of clinical symptoms in the patients with FPVCs.ResultsThe clinical data of 262 patients were analyzed,of which 121(46.18%)were asymptomatic,symptoms of 79(30.15%)were relevant with PVCs(the real symptom group),and symptoms of 62(23.66%)were irrelevant with PVCs(the pseudosymptom group).There was no significant difference between the real symptom group and the pseudosymptom group in symptom severity score and symptom-exercise relevance(P>0.05).Univariate analysis compared the clinical data among the three groups,and then the clinical date different among the three groups were compared between any two groups.The results showed that there was no significant difference in age,marital status,occupation type,education level,medical insurance type,combination with recent infection,coronary heart disease,hypertension,diabetes,cerebral infarction,chronic obstructive pulmonary disease,hemoglobin level,average heart rate(HR),number of PVCs in 24 hours,PVCs origin,QRS wave width of PVCs,coupling interval,HR variability,and PVCs-HR relevance(P>0.05).The proportion of male,smoking,drinking,well-distributed PVCs in the asymptomatic group was higher than that of the real symptom group and the pseudosymptom group(P<0.05).The PVCs duration of the asymptomatic group was longer than that of the real symptom group and the pseudosymptom group(P<0.05).The PVCs load and LVEF of the real symptom group were higher than of the asymptomatic group and the pseudosymptom group(P<0.05).The coupling interval/cardiac cycle of the real symptom group was smaller than that of the asymptomatic group and the pseudosymptom group(P<0.05).The SAS scale score of the pseudosymptom group was higher than that of the asymptomatic group and the ture symptom group(P<0.05),and the SAS scale score of the ture symptom group was higher than that of the asymptomatic group(P<0.05).The sleep quality of the real symptom group and the pseudosymptom group were worse than that of the asymptomatic group(P<0.05).The results of Logistic regression analysis between the three groups showed that,compared with the asymptomatic group,the PVCs distribution type(uniform distribution),sleep quality,coupling interval/cardiac cycle were independent factors associated with real symptoms;sex(female),anxiety,sleep quality,and PVCs distribution type(uniform distribution)are independent factors associated with pseudosymptoms.The results of Spearman correlation analysis showed that the severity of the real symptoms were positively correlated with the LVEF,24 hour total number of PVCs and the PVCs load(P<0.05).The severity of the pseudosymptoms were positively correlated with anxiety and dyssomnia(P<0.05),and female has more serious pseudosymptoms than male(P<0.05).Conclusions(1)About half of the patients with FPVCs have no clinical symptoms,and a quarter of FPVCs patients have no symptoms-PVCs relevance.More attention should be paid on the symptoms-PVCs relevance when treating with FPVCs.(2)The symptoms in patients with FPVCs were not completely depend on the number of PVCs.Patients with real symptoms have heavier PVCs load,shorter coupling interval/cardiac cycle ratio.The dyssomnia aggravate the true symptoms.The worse the anxiety or sleep quality,the more serious the pseudosymptom.Patients of male,longer PVCs duration,lower LVEF,well-distributed PVCs,lower anxiety degree and better sleep quality tend to be asymptomatic.(3)The treatment strategy of anti-anxiety and sleep quality improvement may be effective in improving the symptoms of FPVCs patients.