TY - JOUR
T1 - Radiofrequency ablation of frequent, idiopathic premature ventricular complexes
T2 - Comparison with a control group without intervention
AU - Bogun, Frank
AU - Crawford, Thomas
AU - Reich, Stephen
AU - Koelling, Todd M.
AU - Armstrong, William
AU - Good, Eric
AU - Jongnarangsin, Krit
AU - Marine, Joseph E.
AU - Chugh, Aman
AU - Pelosi, Frank
AU - Oral, Hakan
AU - Morady, Fred
PY - 2007/7
Y1 - 2007/7
N2 - Background: Idiopathic premature ventricular complexes (PVCs) usually are considered benign, even when frequent. However, case reports have demonstrated a possible link between frequent PVCs and left ventricular (LV) dysfunction. In addition, frequent PVCs recently were demonstrated to be associated with increased LV dimensions and cardiomyopathy. Methods: Among 60 consecutive patients with idiopathic, frequent PVCs (>10/hour), a reduced LV ejection fraction (EF; mean 34% ± 13%) was present in 22 (37%) patients. Patients with decreased LV function had a greater PVC burden on a 24-hour Holter monitor than patients with normal EF (37% ± 13% vs. 11% ± 10% of all QRS complexes; P <.0001). There was a significant inverse correlation between the PVC burden and the EF before ablation (r = 0.73, P <.0001). Results: The PVCs originated in the right ventricular outflow tract in 31 (52%) of 60 patients, the LV outflow tract in 9 (15%) of 60 patients, and in other sites in 13 (22%) of 60 patients. The site of PVC origin could not be determined in seven patients. Ablation was completely successful in 48 (80%) patients. In patients with an abnormal EF before ablation, LV function normalized in 18 (82%) of 22 patients from a baseline of 34% to 59% ± 7% (P <.0001) within 6 months. In the four patients in whom ablation was ineffective, the EF further declined from 34% ± 10% to 25% ± 7% (P = .06) during follow-up. In a control group of 11 patients with a similar PVC burden (30% ± 8%) and a reduced EF (28% ± 13%) who did not undergo ablation, the EF remained unchanged in 10/11 patients over 19 ± 17 months of follow-up and one patient underwent heart transplantation. Conclusion: LV dysfunction in the setting of frequent, idiopathic PVCs may represent a form of cardiomyopathy that can be reversed by catheter ablation of the PVCs.
AB - Background: Idiopathic premature ventricular complexes (PVCs) usually are considered benign, even when frequent. However, case reports have demonstrated a possible link between frequent PVCs and left ventricular (LV) dysfunction. In addition, frequent PVCs recently were demonstrated to be associated with increased LV dimensions and cardiomyopathy. Methods: Among 60 consecutive patients with idiopathic, frequent PVCs (>10/hour), a reduced LV ejection fraction (EF; mean 34% ± 13%) was present in 22 (37%) patients. Patients with decreased LV function had a greater PVC burden on a 24-hour Holter monitor than patients with normal EF (37% ± 13% vs. 11% ± 10% of all QRS complexes; P <.0001). There was a significant inverse correlation between the PVC burden and the EF before ablation (r = 0.73, P <.0001). Results: The PVCs originated in the right ventricular outflow tract in 31 (52%) of 60 patients, the LV outflow tract in 9 (15%) of 60 patients, and in other sites in 13 (22%) of 60 patients. The site of PVC origin could not be determined in seven patients. Ablation was completely successful in 48 (80%) patients. In patients with an abnormal EF before ablation, LV function normalized in 18 (82%) of 22 patients from a baseline of 34% to 59% ± 7% (P <.0001) within 6 months. In the four patients in whom ablation was ineffective, the EF further declined from 34% ± 10% to 25% ± 7% (P = .06) during follow-up. In a control group of 11 patients with a similar PVC burden (30% ± 8%) and a reduced EF (28% ± 13%) who did not undergo ablation, the EF remained unchanged in 10/11 patients over 19 ± 17 months of follow-up and one patient underwent heart transplantation. Conclusion: LV dysfunction in the setting of frequent, idiopathic PVCs may represent a form of cardiomyopathy that can be reversed by catheter ablation of the PVCs.
KW - Cardiomyopathy
KW - Left ventricular dysfunction
KW - Premature ventricular complexes
KW - Radiofrequency ablation
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U2 - 10.1016/j.hrthm.2007.03.003
DO - 10.1016/j.hrthm.2007.03.003
M3 - Article
C2 - 17599667
AN - SCOPUS:34250763270
SN - 1547-5271
VL - 4
SP - 863
EP - 867
JO - Heart Rhythm
JF - Heart Rhythm
IS - 7
ER -