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Premature ventricular complexes may be a cause of chronic cough

Reuters Health • The Doctor's Channel Daily Newscast

NEW YORK (Reuters Health) – New research suggests that premature ventricular complexes (PVCs) may play a role in some cases of chronic cough. However, the findings indicate that PVCs are seldom the sole cause.

Prior research has linked various arrhythmias with chronic cough, but data from prospective studies has been lacking, Dr. Sebastian M. Stec, from Grochowski Hospital, Warsaw, Poland, and colleagues note.

The study involved 120 patients without organic heart disease who were referred for the evaluation of symptomatic PVCs. PVC-associated coughs were defined as ones that occurred immediately after spontaneous or induced PVC.

Ten patients had a chronic cough, according to the report in the June issue of Chest. However, PVCs were implicated as the sole cause of the cough in just one patient.

In five patients, PVCs were thought to play a contributing role to the cough. Other causes seen in these patients included nonasthmatic eosinophilic bronchitis, gastroesophageal reflux disease, and chronic sinusitis.

In the remaining four patients, cough episodes showed no temporal relationship with PVCs. In addition, successful antiarrhythmic therapy did not reduce the frequency of cough episodes.

Subjects with PVC-related cough had a more severe perception of arrhythmia symptoms than did subjects without cough, the authors note.

PVC-related cough resolved after radiofrequency ablation in 4 patients, oral antiarrhythmic therapy in 1 patient, and after spontaneous PVC remission in 1 patient.

“PVC may be associated with chronic cough, probably by cardiopulmonary reflex,” the authors conclude. “Because additional cough-provoking conditions are common in patients with PVC-associated cough, interdisciplinary cooperation is necessary to explain the mechanisms of cough in order to initiate effective treatment.”

Chest 2009;135:1535-1541.