Prevalence and prognostic significance of exercise-induced nonsustained ventricular tachycardia in asymptomatic volunteers: BLSA (Baltimore Longitudinal Study of Aging)

Joseph Marine, Veena Shetty, Grant V. Chow, Jeanette G. Wright, Gary Gerstenblith, Samer S. Najjar, Edward Lakatta, Jerome L. Fleg

Research output: Contribution to journalArticle

Abstract

Objectives This study sought to determine the clinical predictors and prognostic significance of exercise-induced nonsustained ventricular tachycardia (NSVT) in a large population of asymptomatic volunteers. Background Prior studies have reported variable risk associated with exercise-induced ventricular arrhythmia. Methods Subjects in the BLSA (Baltimore Longitudinal Study of Aging) free of known cardiovascular disease who completed at least 1 symptom-limited exercise treadmill test between 1977 and 2001 were included. NSVT episodes were characterized by QRS morphology, duration, and rate. Subjects underwent follow-up clinical evaluation every 2 years. Results The 2,099 subjects (mean age: 52 years; 52.2% male) underwent a mean of 2.7 exercise tests, in which 79 (3.7%) developed NSVT with exercise on at least 1 test. The median duration of NSVT was 3 beats (≤5 beats in 84%), and the median rate was 175 beats/min. Subjects with (vs. without) NSVT were older (67 ± 12 years vs. 51 ± 17 years, p <0.0001) and more likely to be male (80% vs. 51%, p <0.0001) and to have baseline electrocardiographic abnormalities (50% vs. 17%, p <0.0001) or ischemic ST-segment changes with exercise (20% vs. 10%, p = 0.004). Over a mean follow-up of 13.5 ± 7.7 years, 518 deaths (24.6%) occurred. After multivariable adjustment for age, sex, and coronary risk factors, exercise-induced NSVT was not significantly associated with total mortality (hazard ratio: 1.30; 95% confidence interval: 0.89 to 1.90; p = 0.17). Conclusions Exercise-induced NSVT occurred in nearly 4% of this asymptomatic adult cohort. This finding increased with age and was more common in men. After adjustment for clinical variables, exercise-induced NSVT did not independently increase the risk of total mortality.

Original languageEnglish (US)
Pages (from-to)595-600
Number of pages6
JournalJournal of the American College of Cardiology
Volume62
Issue number7
DOIs
StatePublished - Aug 13 2013

Fingerprint

Baltimore
Ventricular Tachycardia
Longitudinal Studies
Volunteers
Exercise
Exercise Test
Mortality
Cardiac Arrhythmias
Cardiovascular Diseases
Confidence Intervals

Keywords

  • aging
  • exercise testing
  • ventricular tachycardia

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Prevalence and prognostic significance of exercise-induced nonsustained ventricular tachycardia in asymptomatic volunteers : BLSA (Baltimore Longitudinal Study of Aging). / Marine, Joseph; Shetty, Veena; Chow, Grant V.; Wright, Jeanette G.; Gerstenblith, Gary; Najjar, Samer S.; Lakatta, Edward; Fleg, Jerome L.

In: Journal of the American College of Cardiology, Vol. 62, No. 7, 13.08.2013, p. 595-600.

Research output: Contribution to journalArticle

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title = "Prevalence and prognostic significance of exercise-induced nonsustained ventricular tachycardia in asymptomatic volunteers: BLSA (Baltimore Longitudinal Study of Aging)",
abstract = "Objectives This study sought to determine the clinical predictors and prognostic significance of exercise-induced nonsustained ventricular tachycardia (NSVT) in a large population of asymptomatic volunteers. Background Prior studies have reported variable risk associated with exercise-induced ventricular arrhythmia. Methods Subjects in the BLSA (Baltimore Longitudinal Study of Aging) free of known cardiovascular disease who completed at least 1 symptom-limited exercise treadmill test between 1977 and 2001 were included. NSVT episodes were characterized by QRS morphology, duration, and rate. Subjects underwent follow-up clinical evaluation every 2 years. Results The 2,099 subjects (mean age: 52 years; 52.2{\%} male) underwent a mean of 2.7 exercise tests, in which 79 (3.7{\%}) developed NSVT with exercise on at least 1 test. The median duration of NSVT was 3 beats (≤5 beats in 84{\%}), and the median rate was 175 beats/min. Subjects with (vs. without) NSVT were older (67 ± 12 years vs. 51 ± 17 years, p <0.0001) and more likely to be male (80{\%} vs. 51{\%}, p <0.0001) and to have baseline electrocardiographic abnormalities (50{\%} vs. 17{\%}, p <0.0001) or ischemic ST-segment changes with exercise (20{\%} vs. 10{\%}, p = 0.004). Over a mean follow-up of 13.5 ± 7.7 years, 518 deaths (24.6{\%}) occurred. After multivariable adjustment for age, sex, and coronary risk factors, exercise-induced NSVT was not significantly associated with total mortality (hazard ratio: 1.30; 95{\%} confidence interval: 0.89 to 1.90; p = 0.17). Conclusions Exercise-induced NSVT occurred in nearly 4{\%} of this asymptomatic adult cohort. This finding increased with age and was more common in men. After adjustment for clinical variables, exercise-induced NSVT did not independently increase the risk of total mortality.",
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AU - Shetty, Veena

AU - Chow, Grant V.

AU - Wright, Jeanette G.

AU - Gerstenblith, Gary

AU - Najjar, Samer S.

AU - Lakatta, Edward

AU - Fleg, Jerome L.

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N2 - Objectives This study sought to determine the clinical predictors and prognostic significance of exercise-induced nonsustained ventricular tachycardia (NSVT) in a large population of asymptomatic volunteers. Background Prior studies have reported variable risk associated with exercise-induced ventricular arrhythmia. Methods Subjects in the BLSA (Baltimore Longitudinal Study of Aging) free of known cardiovascular disease who completed at least 1 symptom-limited exercise treadmill test between 1977 and 2001 were included. NSVT episodes were characterized by QRS morphology, duration, and rate. Subjects underwent follow-up clinical evaluation every 2 years. Results The 2,099 subjects (mean age: 52 years; 52.2% male) underwent a mean of 2.7 exercise tests, in which 79 (3.7%) developed NSVT with exercise on at least 1 test. The median duration of NSVT was 3 beats (≤5 beats in 84%), and the median rate was 175 beats/min. Subjects with (vs. without) NSVT were older (67 ± 12 years vs. 51 ± 17 years, p <0.0001) and more likely to be male (80% vs. 51%, p <0.0001) and to have baseline electrocardiographic abnormalities (50% vs. 17%, p <0.0001) or ischemic ST-segment changes with exercise (20% vs. 10%, p = 0.004). Over a mean follow-up of 13.5 ± 7.7 years, 518 deaths (24.6%) occurred. After multivariable adjustment for age, sex, and coronary risk factors, exercise-induced NSVT was not significantly associated with total mortality (hazard ratio: 1.30; 95% confidence interval: 0.89 to 1.90; p = 0.17). Conclusions Exercise-induced NSVT occurred in nearly 4% of this asymptomatic adult cohort. This finding increased with age and was more common in men. After adjustment for clinical variables, exercise-induced NSVT did not independently increase the risk of total mortality.

AB - Objectives This study sought to determine the clinical predictors and prognostic significance of exercise-induced nonsustained ventricular tachycardia (NSVT) in a large population of asymptomatic volunteers. Background Prior studies have reported variable risk associated with exercise-induced ventricular arrhythmia. Methods Subjects in the BLSA (Baltimore Longitudinal Study of Aging) free of known cardiovascular disease who completed at least 1 symptom-limited exercise treadmill test between 1977 and 2001 were included. NSVT episodes were characterized by QRS morphology, duration, and rate. Subjects underwent follow-up clinical evaluation every 2 years. Results The 2,099 subjects (mean age: 52 years; 52.2% male) underwent a mean of 2.7 exercise tests, in which 79 (3.7%) developed NSVT with exercise on at least 1 test. The median duration of NSVT was 3 beats (≤5 beats in 84%), and the median rate was 175 beats/min. Subjects with (vs. without) NSVT were older (67 ± 12 years vs. 51 ± 17 years, p <0.0001) and more likely to be male (80% vs. 51%, p <0.0001) and to have baseline electrocardiographic abnormalities (50% vs. 17%, p <0.0001) or ischemic ST-segment changes with exercise (20% vs. 10%, p = 0.004). Over a mean follow-up of 13.5 ± 7.7 years, 518 deaths (24.6%) occurred. After multivariable adjustment for age, sex, and coronary risk factors, exercise-induced NSVT was not significantly associated with total mortality (hazard ratio: 1.30; 95% confidence interval: 0.89 to 1.90; p = 0.17). Conclusions Exercise-induced NSVT occurred in nearly 4% of this asymptomatic adult cohort. This finding increased with age and was more common in men. After adjustment for clinical variables, exercise-induced NSVT did not independently increase the risk of total mortality.

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