{"id":40,"date":"2009-01-17T16:26:14","date_gmt":"2009-01-17T15:26:14","guid":{"rendered":"https:\/\/blogs.bmj.com\/heart-journalscan\/?p=40"},"modified":"2015-11-12T13:13:28","modified_gmt":"2015-11-12T12:13:28","slug":"exercise-induced-arrhythmia-associated-with-increased-mortality","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/heart\/2009\/01\/17\/exercise-induced-arrhythmia-associated-with-increased-mortality\/","title":{"rendered":"Exercise induced arrhythmia associated with increased mortality"},"content":{"rendered":"

<\/p>\n

The prognostic importance of exercise-induced ventricular arrhythmia (EIVA) remains unclear. Left bundle branch block (LBBB)-morphology ventricular ectopics may originate from the right ventricular outflow tract and are often benign, whereas right bundle branch block (RBBB)-morphology ventricular ectopics may originate from the left ventricular and may be associated with left ventricular (LV) disease or depressed LV function.<\/p>\n

In a retrospective cohort study, Eckart and colleagues investigated the relationship between the presence (n = 585) or absence (n = 2340) of EIVA during exercise stress testing and future rates of adverse cardiovascular events. Patients were matched by age, sex and risk factor profile.<\/p>\n

During an average follow up period of 24 months, mortality rates were higher among patients with EIVA as compared to those without (5.3% vs 1.8%, p<0.001). Survival was worst among the group with RBBB-morphology or multiple-morphology EIVA (6.9%), whereas patients with LBBB-morphology EIVA had a mortality rate similar to those without EIVA (2.5%). \u00a0Furthermore, among patients without known coronary artery disease any RBBB-morphology EIVA was associated with death (HR 2.73 [95% CI, 1.78 to 4.13]; p<0.001) but LBBB-morphology EIVA was not (HR 0.82 [95% CI, 0.18 to 2.04]; p=0.72).<\/p>\n

Although not all LBBB-morphology EIVA can be dismissed as low risk, the authors suggest that at the very least the presence of RBBB-morphology EIVA may be a useful indicator of high cardiovascular risk, and should prompt further investigation.<\/p>\n