Myocardial performance is reduced immediately prior to ventricular ectopy

Poul Erik Bloch Thomsen*, Thomas Fritz Hansen, Christian Jons, Thue Olsen, Arne Johannessen, Knud Særmark, Scott McNitt, Mark Haigney, Peter Sogaard

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


We recently demonstrated local voltage potentials indicating conduction impairment and block in the sinus beats preceding ventricular premature beats (VPBs) originating in the ventricular outflow tracts. The purpose of this study was to test the hypothesis that impairment of impulse conduction would also lead to changes in the contractile performance of sinus beats preceding ventricular ectopy using Tissue Doppler echocardiography. Twenty-three consecutive patients with VPBs were examined in the apical 4-chamber view with a frame rate of 150 Hz (GE VIVID VII). Eleven patients had no structural heart disease, 5 had dilated cardiomyopathy, 4 had ischemic heart disease, 2 had arrhythmogenic right ventricular dysplasia, and 1 had aortic stenosis. The ectopy originated in the ventricular outflow tracts in 15 patients and in the left ventricle 8. Eleven of the patients underwent radiofrequency ablation of the VPBs. Tissue Doppler imaging demonstrated a highly statistically significant decrease in myocardial performance in the last sinus beat before the VPB compared to earlier sinus beats. Thus, ejection time (time to peak end-systolic contraction) and peak systolic velocity shortened significantly (P <.001 for both) with a subsequent reduction in systolic shortening (end-systolic displacement; P <.001). Ventricular ectopy is preceded by a significant decrease in myocardial performance in the last sinus beat preceding VPBs as observed in consecutive patients with a broad variety of heart conditions pointing to a mutual underlying electrical mechanism (ie, localized conduction block confined to an area surrounding the ectopic pacemaker).

Original languageEnglish
Pages (from-to)86-90
Number of pages5
JournalHeart Rhythm
Issue number1
StatePublished - Jan 2012
Externally publishedYes


  • Cardiomyopathy
  • Conduction impairment
  • Tissue Doppler imaging
  • Ventricular premature beats


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