TY - JOUR
T1 - Prevalence and prognostic significance of exercise-induced nonsustained ventricular tachycardia in asymptomatic volunteers
T2 - BLSA (Baltimore Longitudinal Study of Aging)
AU - Marine, Joseph E.
AU - Shetty, Veena
AU - Chow, Grant V.
AU - Wright, Jeanette G.
AU - Gerstenblith, Gary
AU - Najjar, Samer S.
AU - Lakatta, Edward G.
AU - Fleg, Jerome L.
N1 - Funding Information:
This research was supported in part by the Intramural Research Program of the National Institute on Aging of the National Institutes of Health and the MedStar Research Institute . Dr. Najjar has received research support from HeartWare Inc . All other authors have reported that they have no relationships relevant to the content of this paper to disclose.
PY - 2013/8/13
Y1 - 2013/8/13
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.
KW - aging
KW - exercise testing
KW - ventricular tachycardia
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U2 - 10.1016/j.jacc.2013.05.026
DO - 10.1016/j.jacc.2013.05.026
M3 - Article
C2 - 23747767
AN - SCOPUS:84881356531
SN - 0735-1097
VL - 62
SP - 595
EP - 600
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
IS - 7
ER -