Introduction

From: Contemporary Cardiology: Management of Cardiac Arrhythmias Edited by: L. I. Ganz © Humana Press Inc., Totowa, NJ

Age Groups Holter Monitor Test
Fig. 1. Density of ventricular ectopy in unselected patients undergoing 24-h Holter monitoring as a function of age. (From: Kostis JB. Circulation 1981;63:1353.)

Incidence of NSVT

The actual incidence of NSVT in the general population is unknown (see Fig. 1). In asymptomatic individuals with no apparent heart disease, NSVT is rare (1-4%) (3,4-10). NSVT may occur in the general population at a frequency too small to be detectable during an average 24-h observational period. Treadmill testing can detect NSVT in about 1% of an unselected population (7,8).

A relationship does exist between the extent of structural heart disease and the prevalence of NSVT (11-13). In the CHF STAT trial, 80% of patients with congestive heart failure (CHF) had NSVT on routine 24-h Holter monitoring (14). Other studies of patients with heart failure confirm a high frequency of NSVT with routine monitoring (15,16). In the GESICA trial, the incidence of NSVT was 50.3%. Prolonged monitoring of most patients with cardiomyopathy and CHF will reveal NSVT. NSVT is commonly associated with many forms of heart disease, including ischemic heart disease, cardiomy-opathy (dilated, infiltrative, and hypertrophic), congenital heart disease, valvular heart disease, myocarditis, long QT syndrome (LQTS), and right ventricular dysplasia. Approximately 35-50% of patients with acute myocardial infarction (MI) have NSVT during the acute phase of the MI, and 5-10% of those with history of MI will have NSVT in the chronic phase (17-19,20-23).

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