Reversal of premature ventricular complexes induced cardiomyopathy. Influence of concomitant structural heart disease
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Date
2018-05
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Cardiological Society of India
Abstract
Background
We examined the effect of radiofrequency (RF) catheter ablation of premature ventricular complexes (PVCs) on left ventricle (LV) function recovery in patients with LV dysfunction, regardless the presence of structural heart disease (SHD).
Methods
Seventy seven patients with impaired LV ejection fraction (EF) (37.1 ± 9.4), suspected to have PVCs cardiomyopathy (PVC-CM) (>10% PVCs burden), referred for RF ablation were enrolled, and divided into 2 groups according to the presence of SHD. SHD was ruled out by echocardiography, coronary angiography or MRI. CARTO 3 mapping system was used employing activation mapping in the majority of cases. Initial success was defined as complete elimination or residual PVCs ≤ 10 beats/30 min. Long term success was defined as reduction in PVCs burden >80% on follow-up holter. Echocardiography was done after 6 months. Improvement of EF >5% was considered significant.
Results
Forty two (55.8%) cases had SHD. PVCs burden was 28.4 ± 9.8%. EF improved to 48.6 ± 10.3. Initial success, overall success, post procedural PVCs burden and EF were comparable in both groups. EF improved in 47(75%) of successful cases with no significant differences between both groups. Post-MI Patients were the least category to improve. PVCs burden before and after ablation were the independent predictors of LVEF recovery by multivariate analysis. Cutoff values of >18%, <8% had 100% sensitivity and 85%, 87% specificity, respectively.
Conclusions
PVCs elimination by RF ablation results in significant improvement even restoration of LV function regardless of PVC origin, or the presence of concomitant SHD. PVCs burden before and after ablation are the main predictors of LVEF recovery.
Description
Keywords
PVCs, PVCs cardiomyopathy (PVC-CM)
Citation
Abdelhamid Mohamed A., Samir Rania. Reversal of premature ventricular complexes induced cardiomyopathy. Influence of concomitant structural heart disease. Indian Heart Journal. 2018 May; 70(3): 410-415