Significance and reproducibility of exercise-related idiopathic ventricular arrhythmias

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Abstract
Fifty-five patients with a severe idiopathic ventricular arrhythmia were subjected to a follow-up study three to seven years after the discovery of the arrhythmia. During this time only one sudden cardiac death had occurred. Special attention was paid to comparing the clinical significance and reproducibility of arrhythmias either aggravated or suppressed by exercise. For this reason, 20 of the patients, 10 with aggravation and 10 with suppression of the arrhythmia by exercise, were studied more extensively by repeated exercise stress testing, pulse tracings, and echo- and phonocardiography. Patients with an arrhythmia aggravated by exercise exhibited a significantly higher frequency of latent or manifest cardiovascular disease as compared to patients with arrhythmias suppressed by exercise (10 v. three patients; P < 0.05). A high intra-individual inter-test reproducibility of ventricular arrhythmias was seen in this group of patients with very pronounced arrhythmias. Also the arrhythmia pattern on exercise, i.e. aggravation or suppression of arrhythmia respectively, showed a good reproducibility. Although patients with aggravating arrhythmia during exercise had a higher frequency of cardiovascular disease, the three to seven year prognosis for these patients did not differ from that of patients with arrhythmias suppressed by exercise.

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