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Angiology
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Cerebrovascular Hemodynamic Inefficiency of Premature Ventricular Contractions

Marc D. Malkoff, M.D.

The Souers Stroke Institute and The Section of Neurointensive Care, Department of Neurology, Saint Louis University Health Sciences Center, St. Louis, Missouri

Camilo R. Gomez, M.D., F.A.C.A.

The Souers Stroke Institute and The Section of Neurointensive Care, Department of Neurology, Saint Louis University Health Sciences Center, St. Louis, Missouri

Geraldine Myles, R.N., M.S.N.

The Souers Stroke Institute and The Section of Neurointensive Care, Department of Neurology, Saint Louis University Health Sciences Center, St. Louis, Missouri

Salvador Cruz-Flores, M.D.

The Souers Stroke Institute and The Section of Neurointensive Care, Department of Neurology, Saint Louis University Health Sciences Center, St. Louis, Missouri

Transcranial Doppler (TCD) measurements of middle cerebral artery (MCA) blood flow velocities were recorded and synchronized with electrocardiographic (EKG) recordings in 52 EKG/TCD complexes in 4 patients. Thirty-seven normal sinus beats and 13 conductive and 2 nonconductive premature ventricular contractions (PVCs) were examined. Mean velocities averaged 45 ± 4 cm/sec for normal sinus rhythm (NSR) vs 26 ± 4 cm/sec in the PVC group (P = 0.007). Peak systolic velocities averaged 74 ± 6 cm/sec for the NSR and 45 ± 7 cm/sec in the PVC group (P = 0.016). The latency between the QRS complexes and corresponding TCD wave forms (QRS-SU) averaged 0.12 ± 0.03 sec in NSR and 0.17 ± 0.04 sec for the PVC group (P < 0.001). In addition, QRS-SU was inversely related to all velocities. PVCs appeared to be less hemodynamically efficient than NSR. The lower blood flow velocities and increased QRS-SU may result from lower stroke volume and delayed ventricular contraction associated with the aberrant QRS complex.

Angiology, Vol. 47, No. 1, 51-56 (1996)
DOI: 10.1177/000331979604700107
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