Empiric ablation of asymptomatic PVCs when there is greater than 20% burden but normal left ventricular function—An argument in support of catheter ablation

Han, Frederick T.

doi:10.1016/j.hroo.2021.02.004

Cited by 4 publications

(2 citation statements)

References 34 publications

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“… 15 Although PVC burden of >24% was identified by one study as a cut-off for risk of cardiomyopathy, findings from other studies showed the burden as low as 5–6% to be associated with increased risk of the same. 16 , 17 Higher prevalence of multiform PVCs was also reported to be associated with reduced LVEF in a retrospective series. 18 Regardless of whether the pleomorphic PVCs were the cause or the manifestation of a pre-existing cardiomyopathy, several trials have demonstrated significant reduction in PVC burden and improvement in LVEF following catheter ablation, in agreement with our current findings.…”

Section: Discussionmentioning

confidence: 86%

Best ablation strategy in patients with premature ventricular contractions with multiple morphology: a single-centre experience

et al. 2023

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Aims This study aimed to examine the clinical benefits of targeted ablation of all Premature ventricular complex (PVC) morphologies vs. predominant PVC only. Methods and results A total of 171 consecutive patients with reduced left ventricular ejection fraction (LVEF) and ≥2 PVC morphology with high burden (>10%/day) undergoing their first ablation procedure were included in the analysis. At the initial procedure, prevalent PVC alone was ablated in the majority. However, at the redo, all PVC morphologies were targeted for ablation. : At the first procedure, 152 (89%) patients received ablation of the dominant PVC only. In the remaining 19 (11%) patients, all PVC morphologies were ablated. At two years, high PVC burden was detected in 89 (52%) patients. Repeat procedure was performed in 78 of 89, where all PVC morphologies were ablated. At 5 years after the repeat procedure, 71 (91%) had PVC burden of <5% [3.8 ± 1.1% vs. 15.4 ± 4.3% in successful vs. failed subjects (P < 0.001)]. In patients with low PVC burden after the initial procedure, LVEF improved from 37.5% to 41.6% [mean difference (MD): 3.39 ± 2.9%, P < 0.001], whereas a reduction in LVEF from 39.8% to 34.5% (MD: 6.45 ± 4.7%, P < 0.001) was recorded in patients with high PVC burden. One year after the repeat procedure, LVEF improved from 36.2% to 41.7% (MD: 5.5 ± 4.3%, P < 0.001) in patients with successful ablation. Conclusion In this observational series, ablation of all PVC morphologies was associated with significantly lower PVC burden and improvement of LVEF at long-term follow-up, compared with ablation of the dominant morphology only.

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Section: Discussionmentioning

confidence: 86%

Best ablation strategy in patients with premature ventricular contractions with multiple morphology: a single-centre experience

et al. 2023

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“…Premature ventricular complexes (PVCs) are one of the most encountered cardiac arrhythmia. PVCs with a burden of > 20% may be independently associated with PVC-induced cardiomyopathy [ 1 ]. Catheter ablation is more efficacious than medicines to treat PVCs in patients presenting with monomorphic premature complexes.…”

Section: Introductionmentioning

confidence: 99%

Electrophysiological characteristics and catheter ablation of ventricular arrhythmias arising from the superior septal left ventricle

Liu,

Tian,

Jiang

et al. 2024

BMC Cardiovasc Disord

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Background and aims Electrophysiological characteristics and radiofrequency catheter ablation (RFCA) of premature ventricular contractions (PVCs) originating from the superior septal left ventricle (SSLV) have not yet been fully characterized. Methods and results This study included 247 patients who underwent RFCA for PVCs arising from the ventricular outflow tract between February 2020 and August 2022. The successful ablation site was on the SSLV in 37 of the 247 patients. In 12 (32.4%) of those 37 patients, a low amplitude and high frequency spiky potential (SP) was recognized. Five patients showed a narrow QRS duration (86.8 ± 4.6 ms), with a discrete SP observed in PVCs and sinus rhythm, which showed an isoelectric line with the ventricular electrogram at the earliest activation site. Seven patients showed a wide QRS duration (131.6 ± 4.5 ms), with SP observed in PVCs without an isoelectric line with the ventricular electrogram. RFCA was successful at the site of the earliest SP in all 12 patients. The time from SP onset at the successful ablation site to the QRS onset (local activation time) was 30 ± 12 ms, which differed significantly from that for the remaining 25 patients withoutSP(22.1 ± 7.1 ms, P < 0.05). Conclusions SPs were recorded in 12 (32.4%) of the 37 patients with PVCs originating from the SSLV. The morphology of the PVCs may show a narrow or wide QRS duration and the target site for successful ablation should be identified by the earliest SP.

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Mechanisms, time course and predictability of premature ventricular contractions cardiomyopathy—an update on its development and resolution

et al. 2021

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Empiric ablation of asymptomatic PVCs when there is greater than 20% burden but normal left ventricular function—An argument in support of catheter ablation

Cited by 4 publications

References 34 publications

Best ablation strategy in patients with premature ventricular contractions with multiple morphology: a single-centre experience

Best ablation strategy in patients with premature ventricular contractions with multiple morphology: a single-centre experience

Electrophysiological characteristics and catheter ablation of ventricular arrhythmias arising from the superior septal left ventricle

Mechanisms, time course and predictability of premature ventricular contractions cardiomyopathy—an update on its development and resolution

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