Radiofrequency catheter ablation of premature ventricular complexes from right ventricular outflow tract improves left ventricular dilation and clinical status in patients without structural heart disease

Takemoto, Masao; Yoshimura, Hitoshi; Ohba, Yoshihito; Matsumoto, Yasuharu; Yamamoto, Umpei; Mohri, Masahiro; Yamamoto, Hideo; Otsuka, Hideki

doi:10.1016/j.jacc.2004.12.073

Cited by 306 publications

(248 citation statements)

References 28 publications

(27 reference statements)

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“…This is consistent with studies from multiple cardiac electrophysiology groups demonstrating that successful ablation of frequent PVCs can improve, and even normalize, reduced ejection fractions among patients with severe systolic dysfunction 10, 11, 27…”

Section: Discussionsupporting

confidence: 89%

“…Similarly, frequent premature ventricular contractions (PVCs) quantified by Holter studies are associated with incident HF and mortality 7, 8. Given evidence that successful ablation of PACs can eradicate AF9 and that successful ablation of frequent PVCs can normalize systolic dysfunction,10, 11 experts in the field now refer to ectopy as a cause of myopathy 12, 13, 14, 15, 16…”

Section: Introductionmentioning

confidence: 99%

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Ectopy on a Single 12‐Lead ECG, Incident Cardiac Myopathy, and Death in the Community

Nguyen

Vittinghoff

Dewland

et al. 2017

JAHA

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BackgroundAtrial fibrillation and heart failure are 2 of the most common diseases, yet ready means to identify individuals at risk are lacking. The 12‐lead ECG is one of the most accessible tests in medicine. Our objective was to determine whether a premature atrial contraction observed on a standard 12‐lead ECG would predict atrial fibrillation and mortality and whether a premature ventricular contraction would predict heart failure and mortality.Methods and ResultsWe utilized the CHS (Cardiovascular Health) Study, which followed 5577 participants for a median of 12 years, as the primary cohort. The ARIC (Atherosclerosis Risk in Communities Study), the replication cohort, captured data from 15 792 participants over a median of 22 years. In the CHS, multivariable analyses revealed that a baseline 12‐lead ECG premature atrial contraction predicted a 60% increased risk of atrial fibrillation (hazard ratio, 1.6; 95% CI, 1.3–2.0; P<0.001) and a premature ventricular contraction predicted a 30% increased risk of heart failure (hazard ratio, 1.3; 95% CI, 1.0–1.6; P=0.021). In the negative control analyses, neither predicted incident myocardial infarction. A premature atrial contraction was associated with a 30% increased risk of death (hazard ratio, 1.3; 95% CI, 1.1–1.5; P=0.008) and a premature ventricular contraction was associated with a 20% increased risk of death (hazard ratio, 1.2; 95% CI, 1.0–1.3; P=0.044). Similarly statistically significant results for each analysis were also observed in ARIC.ConclusionsBased on a single standard ECG, a premature atrial contraction predicted incident atrial fibrillation and death and a premature ventricular contraction predicted incident heart failure and death, suggesting that this commonly used test may predict future disease.

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Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Ectopy on a Single 12‐Lead ECG, Incident Cardiac Myopathy, and Death in the Community

Nguyen

Vittinghoff

Dewland

et al. 2017

JAHA

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“…The evidence of this relation was that ablation of PVC's improved the LV dysfunction [11][12][13][14][15] . There has been an attempt to define the number of PVC's per 24h that constitutes such burden.…”

Section: Pvc's Induced Cardiomyopathymentioning

confidence: 98%

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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“…And according to the total of ventricular extrasystoles, they were divided into 3 groups: lower group <10,000 beats/d, middle group 10000-20000 beats/d, upper group grossly ≥20,000 beats/d. 15 Settlement types were grouped according to where the participants lived.…”

Section: Assessment Protocolmentioning

confidence: 99%

Depressive Symptoms and Risk Factors in Chinese Patients with Premature Ventricular Contractions without Structural Heart Disease

Liang

Huang

Yang

et al. 2009

Clinical Cardiology

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Hypothesis: Our objective was to study depressive symptoms and potential risk factors in Chinese persons with premature ventricular contractions (PVCs) without structural heart disease. Methods: The Zung self-rating depression scale (ZSDS) was used to assess depressive symptoms. Correlations between depressive symptoms and sociodemographic and medical factors were analyzed by logistic regression. Background: Prevalence of depressive symptoms in coronary heart disease (CHD) is higher that in the general population and those for the majority of other chronic symptoms in patients with premature ventricular contractions (PUCS). Results: Of 1,144 patients with PVCs (488 males, 656 females), age 51±23 years, disease duration 1 mo −23 y, a total of 309 (27%) patients were categorized as having depressive symptoms. Depressive symptoms increased with age, income, education level, nationality, PVC count/24h, society support, and settlement type (p<0.05). Univariate logistic regression showed that being female, level of education, age, settlement type, and PVC count/24h significantly correlated with depressive symptoms (p<0.05). Multivariate logistic regression indicated that 5 variables-female sex, education level, settlement type, age, and PVC count/24h significantly and independently related with depressive symptoms (p<0.05). Conclusions:In the Chinese population, depressive symptoms in subjects with PVCs were frequent. The village settlement type, female sex, age, PVC count/24h, and education level were independent risk factors for depressive symptoms. Further research on the relationship between PVCs and depressive symptoms in China is necessary.

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Radiofrequency catheter ablation of premature ventricular complexes from right ventricular outflow tract improves left ventricular dilation and clinical status in patients without structural heart disease

Abstract: These findings suggest that frequent (>20%) RVOT-PVC may be a possible cause of LV dysfunction and/or heart failure, and RFA produces clinical benefits in these patients.

Cited by 306 publications

References 28 publications

Ectopy on a Single 12‐Lead ECG, Incident Cardiac Myopathy, and Death in the Community

Ectopy on a Single 12‐Lead ECG, Incident Cardiac Myopathy, and Death in the Community

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

Depressive Symptoms and Risk Factors in Chinese Patients with Premature Ventricular Contractions without Structural Heart Disease

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