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Clinical recognition of pure premature ventricular complex-induced cardiomyopathy at presentation.

Abstract：

BACKGROUND:Frequent premature ventricular complexes (PVCs) can induce or worsen left ventricular (LV) systolic dysfunction. OBJECTIVE:The purpose of this study was to identify the clinical pattern of patients having a "pure PVC-induced" cardiomyopathy at presentation. METHODS:This prospective multicenter study included 155 consecutive patients (age 55 ± 12 years, 96 men [62%], 23% ±12% mean PVC burden) with LV dysfunction and frequent PVCs submitted for ablation and followed up for at least 12 months. Patients with a previously diagnosed structural heart disease (50 [32%]) and those without complete PVC abolition during follow-up who did not normalize LV ejection fraction (LVEF) (24 [15%]) were excluded from the analysis. RESULTS:Of the remaining 81 patients, 41 (51%) had a successful sustained ablation, did not have normalized LVEF, and were classified as having PVC-worsened nonischemic cardiomyopathy, and 40 (49%) who had normalized LVEF were considered as having pure PVC-induced cardiomyopathy. The latter group had higher baseline PVC burden (27% ± 12% vs 12% ± 8%; P <.001), smaller LV end-diastolic diameter (58 ± 5 mm vs 60 ± 6 mm; P = .05), and shorter intrinsic QRS (105 ± 12 vs 129 ± 24 ms; P <.001). Any of the following baseline characteristics accurately identified patients who will not normalize LVEF after PVC ablation (85% sensitivity, 98% specificity): intrinsic QRS >130 ms, baseline PVC burden <17%, and LV end-diastolic diameter >63 mm. CONCLUSION:Almost half of patients with frequent PVCs and low LVEF of unknown origin normalize LVEF after sustained PVC abolition, and these patients can be identified before ablation.

journal_name

Heart Rhythm

journal_title

Heart rhythm

authors

Penela D,Fernández-Armenta J,Aguinaga L,Tercedor L,Ordoñez A,Bisbal F,Acosta J,Rossi L,Borras R,Doltra A,Ortiz-Pérez JT,Bosch X,Perea RJ,Prat-González S,Soto-Iglesias D,Tolosana JM,Vassanelli F,Cabrera M,Linhart M,M

doi

10.1016/j.hrthm.2017.07.025

subject

Has Abstract

pub_date

2017-12-01 00:00:00

pages

1864-1870

issue

12

eissn

1547-5271

issn

1556-3871

pii

S1547-5271(17)30893-7

journal_volume

14

pub_type

杂志文章,多中心研究

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