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Br Heart J. 1984 February; 51(2): 195–201.
PMCID: PMC481483

Ventricular arrhythmias in idiopathic dilated cardiomyopathy.


Twenty four hour ambulatory electrocardiograms were recorded in 60 patients with idiopathic dilated cardiomyopathy. The diagnosis was based on clinical, laboratory, and cardiac catheterisation findings. All patients had a left ventricular ejection fraction less than 0.55; in 39 it was less than 0.40. Ventricular extrasystoles were evident in all patients: they were rare in 11 (18%), moderately frequent in 24 (40%), and frequent in 25 (42%). Multiform extrasystoles were recorded in 57 patients (95%), paired ventricular extrasystoles in 47 (78%), and non-sustained ventricular tachycardias consisting of three to 19 beats in 25 (42%) of the 60 patients studied. Eight patients had more than five episodes of ventricular tachycardia a day. Patients with atrial fibrillation had the same frequency and grade of ventricular arrhythmias as those with sinus rhythm. Patients with infrequent and frequent ventricular extrasystoles could not be differentiated on the basis of the clinical or haemodynamic findings. The mean values of NYHA functional class, cardiac index, left ventricular end diastolic pressure, and ejection fraction were, however, significantly different in patients with and without ventricular tachycardia. During follow up of 12 +/- 5 months seven patients died; all seven had an ejection fraction less than 0.40. In four patients who died of congestive heart failure, but in only one of the three patients who died a sudden cardiac death, ventricular tachycardia was recorded during ambulatory monitoring. High grade ventricular arrhythmias are often seen in patients with idiopathic dilated cardiomyopathy; patients with ventricular tachycardia have more impairment of left ventricular function than patients without ventricular tachycardia; and ambulatory monitoring may be of little help in identifying patients at increased risk of sudden cardiac death.

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Selected References

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  • Johnson RA, Palacios I. Dilated cardiomyopathies of the adult (first of two parts). N Engl J Med. 1982 Oct 21;307(17):1051–1058. [PubMed]
  • Savage DD, Seides SF, Maron BJ, Myers DJ, Epstein SE. Prevalence of arrhythmias during 24-hour electrocardiographic monitoring and exercise testing in patients with obstructive and nonobstructive hypertrophic cardiomyopathy. Circulation. 1979 May;59(5):866–875. [PubMed]
  • Huang SK, Messer JV, Denes P. Significance of ventricular tachycardia in idiopathic dilated cardiomyopathy: observations in 35 patients. Am J Cardiol. 1983 Feb;51(3):507–512. [PubMed]
  • Fuster V, Gersh BJ, Giuliani ER, Tajik AJ, Brandenburg RO, Frye RL. The natural history of idiopathic dilated cardiomyopathy. Am J Cardiol. 1981 Mar;47(3):525–531. [PubMed]
  • Goodwin JF, Oakley CM. The cardiomyopathies. Br Heart J. 1972 Jun;34(6):545–552. [PMC free article] [PubMed]
  • Ryan M, Lown B, Horn H. Comparison of ventricular ectopic activity during 24-hour monitoring and exercise testing in patients with coronary heart disease. N Engl J Med. 1975 Jan 30;292(5):224–229. [PubMed]
  • Moss AJ, Davis HT, Conard DL, DeCamilla JJ, Odoroff CL. Digitalis-associated cardiac mortality after myocardial infarction. Circulation. 1981 Dec;64(6):1150–1156. [PubMed]
  • Bigger JT, Jr, Weld FM, Rolnitzky LM. Prevalence, characteristics and significance of ventricular tachycardia (three or more complexes) detected with ambulatory electrocardiographic recording in the late hospital phase of acute myocardial infarction. Am J Cardiol. 1981 Nov;48(5):815–823. [PubMed]
  • Segal JP, Stapleton JF, McClellan JR, Waller BF, Harvey WP. Idiopathic cardiomyopathy: clinical features, prognosis and therapy. Curr Probl Cardiol. 1978 Sep;3(6):1–48. [PubMed]
  • Califf RM, McKinnis RA, Burks J, Lee KL, Harrell FE, Jr, Behar VS, Pryor DB, Wagner GS, Rosati RA. Prognostic implications of ventricular arrhythmias during 24 hour ambulatory monitoring in patients undergoing cardiac catheterization for coronary artery disease. Am J Cardiol. 1982 Jul;50(1):23–31. [PubMed]
  • Schulze RA, Jr, Strauss HW, Pitt B. Sudden death in the year following myocardial infarction. Relation to ventricular premature contractions in the late hospitals phase and left ventricular ejection fraction. Am J Med. 1977 Feb;62(2):192–199. [PubMed]
  • von Olshausen K, Schwarz F, Apfelbach J, Röhrig N, Krämer B, Kübler W. Determinants of the incidence and severity of ventricular arrhythmias in aortic valve disease. Am J Cardiol. 1983 Apr;51(7):1103–1109. [PubMed]

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