Cardiothoracic & vascular anaesthesia
Clinical implications of intraoperative premature ventricular contractions for 30-day cardiovascular outcomes after liver transplantation
Authors' conclusion
Complex intraoperative ventricular ectopy, but not isolated PVCs, was independently associated with 30-day MACE in LT recipients. AI-enabled PVC quantification may identify an intraoperative signal associated with postoperative cardiovascular risk, although prospective and external validation is required before clinical application.
Study context
- Population
- Liver transplantation (LT) recipients with continuous intraoperative ECG recordings
- Participants
- 2,290 consecutive LT recipients
- Exposure
- Associations with 30-day major adverse cardiovascular events (MACE) were estimated by multivariable logistic regression across burden tertiles
- MACEn = 515
- Outcome
- 30-day MACE
- Follow-up
- 30 days
Methodological detailsconsecutive LT recipients, validated AI-based detection pipeline, multivariable logistic regression
- Consecutive LT recipients
- Validated AI-based detection pipeline
- Multivariable logistic regression
Main finding
As reported in the abstract
MACE occurred
515 patients
22.5%
Observational data: associations, not effects.
Further findings
Isolated PVC prevalence · did not differ
P = 0.666
Complex PVC prevalence · significantly higher in the MACE group
P < 0.001
30-day MACE by total complex premature ventricular contraction (PVC) burden tertile
| aOR for MACE (95% CI) | ||
|---|---|---|
| T1Comparator not stated · multivariable logistic regression | 1.71 (1.11–2.65) | |
| T2Comparator not stated · multivariable logistic regression | 2.26 (1.47–3.47) | |
| T3Comparator not stated · multivariable logistic regression | 2.79 (1.83–4.27) | |
| 0.20.5125AOR for MACE (log scale) |
PVC detection
- PVCs detected
- 98.2% of patients
30-day MACE by total complex PVC burden tertile
- Graded association with MACE across tertiles
30-day MACE by isolated PVC burden tertile
- Isolated PVC burden was not associated with MACE in any tertile
Sensitivity analyses (hard MACE endpoint excluding arrhythmic components; additional adjustment for isolated PVC burden)
- The association persisted in both sensitivity analyses
Original publication
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