Background Several studies have suggested that ventricular arrhythmias detected by ambulatory ECG (AECG) may identify patients with chronic heart failure (CHF) at high risk for cardiovascular death. However, few studies aim at whether different origins of premature ventricular contraction (PVCs) can hold any prognostic value in CHF patients.

Methods Ventricular arrhythmias were analysed and quantified by use of prespecified criteria on baseline AECG from 206 patients diagnosed with CHF and left ventricular ejection fraction (LVEF) ≤40%. After follow-up, the patients were divided into two groups: survival group and cardiac death group by an independent group. The relationship between cardiovascular mortality and AECG parameters were determined respectively by univariate and multivariate analyses.

Results 206 patients were enrolled and 198 (96.12%) patients were completed in this study. After follow up, there were 37 deaths. A–V block, 24 h-average heart rate, number of PVCs, presence of nonsustained ventricular tachycardia (NSVT), frequency of NSVT episodes, fastest rate of NSVT, PVCs originating from left ventricular inflow tract (LVIT), NSVT originating from LVIT and LOWN grade were univariate predictors of cardiovascular mortality. In multivariate logistic regression analysis, 24 h-average heart rate, number of PVCs, PVCs originating from LVIT and frequency of NSVT episodes were significant independent predictors of cardiovascular mortality.

Conclusion Determinating the location of PVCs by AECG can indicate prognosis of CHF patients.