Premature Ventricular Contraction-Induced Cardiomyopathy

Mei, Yong; Lee, Glenn K.; Klarich, Kyle W.; Grogan, Martha

doi:10.1161/circep.111.963348

Cited by 175 publications

(71 citation statements)

References 76 publications

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“…Although the average LVEF after 5‐week pacing was lower compared to the baseline, the difference did not reach a statistically significant level. One possible reason for this result is that the duration of pacing exposure in our study was shorter compared to animals in previous studies 4, 5. Second, different animal species may have a different vulnerability to cardiomyopathy secondary to VPC.…”

Section: Discussionmentioning

confidence: 62%

“…Some studies showed that frequent VPCs lead to dilated cardiomyopathy with LV dysfunction 4, 5. In swine models with 50% pacing burden during a 14‐week follow‐up, there were progressive increase in LVEDD and LVESD and decrease in LVEF without signs of overt heart failure, such as lethargy, decreased activity, fluid retention, or tachypnea 5.…”

Section: Discussionmentioning

confidence: 99%

“…The irregular beats of frequent VPCs lead to an LV mechanical dyssynchrony, which can contribute to the increase of the LV filling pressures and atrial overload 26, 27. As a result, those hemodynamic changes activate the renin‐angiotensin‐aldosterone system in ventricle and atria through stretch of the heart and inflammatory cytokines, which might be associated with the progression of cardiac remodeling and finally lead to heart failure 4, 28, 29, 30. We speculate that ventricular chamber dilatation and myocardial fibrosis are the consequence from those pathological influences.…”

Section: Discussionmentioning

confidence: 99%

“…However, trigger VPCs with a short coupling interval may carry the risk of initiating ventricular fibrillation (VF) and sudden cardiac death 3. In addition, increased VPC burden can cause dilated cardiomyopathy with left ventricular (LV) dysfunction 4, 5. It has been generally described that VPC‐induced cardiomyopathy could be reversible and appears to be a functional abnormality in human and animal models 6, 7, 8.…”

Section: Introductionmentioning

confidence: 99%

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Beneficial Effect of Renal Denervation on Ventricular Premature Complex Induced Cardiomyopathy

Yamada

Chou

et al. 2017

JAHA

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BackgroundFrequent ventricular premature complexes (VPCs) can lead to the development of dilated cardiomyopathy and sudden cardiac death. Renal artery sympathetic denervation (RDN) may protect the heart from remodeling. This study aimed to investigate the effect of frequent VPCs on structural and electrical properties and whether RDN can protect the heart from remodeling.Methods and ResultsEighteen rabbits were randomized to control (n=6), VPC (n=6), and VPC‐RDN (n=6) groups. Surgical and chemical RDNs were approached through bilateral retroperitoneal flank incisions in the VPC‐RDN group. Pacemakers were implanted to the left ventricular apex to produce 50% VPC burden for 5 weeks in the VPC and VPC‐RDN groups. In addition, ventricular myocardium was harvested for western blot and trichrome stain. Echocardiographic results showed left ventricular enlargement after 5‐week pacing in the VPC group, but not in the VPC‐RDN group, when compared to baseline. In biventricles, ion channel protein expressions of Nav1.5, Cav1.2, Kir2.1, and SERCA2 were similar among 3 groups. However, the degree of biventricular fibrosis was extensive in the VPC group, compared to the control and VPC‐RDN groups. Importantly, ventricular fibrillation inducibility was higher in the VPC group (41%) when comparing to the control (13%; P<0.05) and VPC‐RDN groups (13%; P<0.05), respectively.ConclusionsFrequent VPCs are associated with the development of cardiac structural remodeling and high ventricular fibrillation inducibility. RDN prevents cardiac remodeling and the occurrence of ventricular arrhythmia through antifibrosis.

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Section: Discussionmentioning

confidence: 62%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Beneficial Effect of Renal Denervation on Ventricular Premature Complex Induced Cardiomyopathy

Yamada

Chou

et al. 2017

JAHA

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“…The number varied from 10% to 25%. 16 ; however, high PVC burden does not always result in LV dysfunction even after a long follow-up. 15 The duration of the PVCs is thought to be a determinant of LV dysfunction.…”

Section: Pvc's Induced Cardiomyopathymentioning

confidence: 94%

Are premature ventricular contractions in patients without apparent structural heart disease really safe?

Jazra¹,

Wazni²,

Jaroudi³

2015

ICFJ

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Premature ventricular complexes (PVC) are considered benign when they occur in patients without apparent structural heart disease. They usually originate from the right, or less commonly, left ventricular outflow tract. Their suppression was not beneficial in patients with heart disease like myocardial infarction and cardiomyopathies. Recently it has been shown that their suppression medically or by ablation, improved the left ventricular (LV) dysfunction. This led to the hypothesis that they may contribute to this LV dysfunction especially when they are particularly frequent (> 20000 per day). Because of some overlap with arrhythmogenic right ventricular dysplasia, the evaluation in patients without apparent heart disease should consider an magnetic resonance imaging if the echocardiography was not able to help in diagnosis especially when there is a suspicion.Patients without structural heart disease and low-to modest PVC burdens do not always require treatment.When necessary, treatment for PVCs involves beta-blockers, calcium channel blockers, or other antiarrhythmicdrugs and catheter ablation in selected cases. Catheter ablation can be curative, but it is typically reservedfor drug-intolerant or medically refractory patients with a high PVC burden.

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Premature Atrial and Ventricular Complexes

Löffler

Darby

2020

Electrocardiogram in Clinical Medicine

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Premature Ventricular Contraction-Induced Cardiomyopathy

Cited by 175 publications

References 76 publications

Beneficial Effect of Renal Denervation on Ventricular Premature Complex Induced Cardiomyopathy

Beneficial Effect of Renal Denervation on Ventricular Premature Complex Induced Cardiomyopathy

Are premature ventricular contractions in patients without apparent structural heart disease really safe?

Premature Atrial and Ventricular Complexes

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