Beneficial effects of catheter ablation on left ventricular and right ventricular function in patients with frequent premature ventricular contractions and preserved ejection fraction

Abstract

Frequent PVCs can induce subtle cardiac dysfunction detected by speckle tracking imaging analysis in patients without apparent cardiomyopathy. RFCA can successfully eliminate PVCs and improve cardiac function.

Premature Ventricular Contraction-Induced Cardiomyopathy

“…Our ability to predict the site of origin of the PVCs on surface electrocardiography 65 and to safely access the right ventricular outflow tract and left ventricle (including the pericardium and the aortic cusp region) 66,67 and the use of advanced 3-dimensional mapping tools allows us to precisely localize the PVC foci. Short-term ablation success rates of between 70% and 90% have been reported 10,21,22,54 ; however, the long-term ablative outcomes remain to be studied. Alternative energy sources such as cryoablation may help improve the efficacy-safety profile as compared with traditional radiofrequency-based techniques.…”

“…Other studies also found significant reduction in LV end-diastolic dimensions of between 2 and 8 mm, mitral regurgitation by 75%, and New York Heart Association functional class by nearly 1 class. 14,15,21 Wijnmaalen et al 54 described a significant improvement in radial, circumferential, and longitudinal strain after catheter ablation in patients with frequent PVCs and preserved LVEF. However, like with any invasive intervention, the risks of catheter ablation (whether endocardial or epicardial) must be balanced against any potential benefits.…”

Tachycardia mediated cardiomyopathy: Pathophysiology, mechanisms, clinical features and management

“…Several studies have documented an improvement in LVEF following PVC ablation in nearly all patients along with significant reductions in LV enddiastolic dimensions of between 2 and 8 mm, mitral regurgitation by 75%, and New York Heart Association functional class by nearly 1 class (93,94,95). Significant improvement in radial, circumferential, and longitudinal strain after catheter ablation in patients with frequent PVCs and preserved LVEF has also been shown (96). Short-term ablation success rates of between 70% and 90% have been reported (97,98).…”

Radiofrequency Ablation of Premature Ventricular Ectopy Improves the Efficacy of Cardiac Resynchronization Therapy in Nonresponders

“…(30,31). PVC can not only cause LV dysfunction in patients with no underlying structural heart disease, but they can also worsen LV function in those with known cardiomyopathy and underlying scar (32,33). However, the pathophysiology behind PVC-mediated cardiomyopathy is unclear.…”