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January 20, 1984

Ventricular Ectopy: History, Epidemiology, and Clinical Implications

Author Affiliations

From the Department of Medicine, Division of Internal Medicine, Johns Hopkins University School of Medicine, Baltimore (Dr Horan), and the Department of Medicine, Division of Cardiology, St Louis University (Dr Kennedy).

JAMA. 1984;251(3):380-386. doi:10.1001/jama.1984.03340270058028

IS VENTRICULAR ectopy always a manifestation of a disease process or can it be found in normal persons? When present, should ventricular ectopy always be treated? To answer these questions, one must delve into medical history, a history rich in anecdote and opinion but muddled in its distinction between disease and health. We review herein the historical development of knowledge about, and attitudes toward, ventricular ectopy, the recent reports delineating patients with ventricular ectopy into prognostically different subsets, and the current approach to the treatment of patients with ventricular ectopy.

Historical Perspective  Although the art of palpating the pulse was practiced as early as 500 BC in ancient China,1 it was not until the second century BC that Herophilus described what we now recognize as extrasystoles.2 However, writers after Herophilus did not make reference to extrasystoles per se but rather talked about the "intermittent pulse." The most influential