Recovery from left ventricular dysfunction after ablation of frequent premature ventricular complexes

Yokokawa, Miki; Good, Eric; Crawford, Thomas; Chugh, Aman; Pelosi, Frank; Latchamsetty, Rakesh; Jongnarangsin, Krit; Armstrong, William F.; Ghanbari, Hamid; Oral, Hakan; Morady, Fred; Bogun, Frank

doi:10.1016/j.hrthm.2012.10.011

Cited by 139 publications

(100 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Yokokawa et al [19] studied the time course of recovery of the LV function after catheter ablation. In 87 patients (with mean LVEF 40 ± 10%) the PVC burden was reduced to < 20% in comparison to the initial PVC burden in 75 patients after the catheter ablation procedure.…”

Section: Predictors Of Improved LV Function In Multivariate Analysismentioning

confidence: 99%

See 1 more Smart Citation

The effect of radiofrequency catheter ablation of frequent premature ventricular complexes and arrhythmia burden on left ventricular function

et al. 2017

View full text Add to dashboard Cite

A b s t r a c tBackground: Frequent premature ventricular complexes (PVC) are related to reversible tachycardia-induced cardiomyopathy. However, the role of arrhythmia burden on the outcome of the catheter ablation has not been fully recognised. Aim:The aim of this study was to assess the effect of catheter ablation and PVC burden in patients with and without structural heart disease (SHD) on left ventricular ejection fraction (LVEF). Methods:Transthoracic echocardiography was done before and six months after radiofrequency catheter ablation in 109 consecutive patients (61 men, age 55 ± 17 years) with frequent PVCs. Sixty-five (59.6%) patients had underlying SHD. Results:The catheter ablation procedure was successful in 93 (85.3%) patients. Baseline PVC burden was higher in patients with SHD (22,267 ± 12,934) compared to those without concomitant SHD (15,546 ± 7888), p = 0.005. Nevertheless, patients with LVEF ≤ 50% at baseline presented greater LVEF recovery (from 44% to 56%) than those with LVEF > 50% at baseline after catheter ablation. In both groups, the LVEF improved (p < 0.001); however, no difference was observed between patients with SHD (5.7% ± 1.37%) and without (4.6% ± 0.96%) SHD; p = 0.89. PVC burden was higher in patients with (24,350 ± 2776 PVC/day) compared to those without (17,588 ± 1970 PVC/day) improvement of LVEF. In multivariate regression analysis PVC burden > 20,000/day (but not age, p = 0.95; gender, p = 0.89; presence of SHD, p = 0.53; QRS complex width of the treated PVC, p = 0.21, LVEF before ablation, p = 0.19; and site of origin, p = 47) predicted improvement in LVEF after successful catheter ablation (odds ratio: 3.53; 95% confidence interval: 1.15-10.75; p = 0.023). Conclusions:Catheter ablation of frequent PVCs improves left ventricular function in multivariate analysis predicted improvement of LVEF within six months after the successful catheter ablation procedure in patients with PVC burden exceeding 20,000/24 h.

show abstract

Section: Predictors Of Improved LV Function In Multivariate Analysismentioning

confidence: 99%

“…The majority of patients (51; 68%) with PVC-induced LV dysfunction had recovery of LV function within four months. However, in one-third (24; 32%) of patients, the recovery of LV function took more than four months (mean 12 months; range 5-45 months) [19].…”

Section: Predictors Of Improved LV Function In Multivariate Analysismentioning

confidence: 99%

The effect of radiofrequency catheter ablation of frequent premature ventricular complexes and arrhythmia burden on left ventricular function

et al. 2017

View full text Add to dashboard Cite

show abstract

“…50 In 75 patients with cardiomyopathy caused by frequent premature ventricular ectopics, LV ejection fraction normalized in 5±6 months following successful transcatheter ablation. 51 However, in patients with long-standing tachycardia-induced cardiomyopathy, echocardiographic evaluations following resolution of the causal arrhythmia showed persistence of elevated stroke volumes and LV end-systolic and end-diastolic volumes, as well as diffuse fibrosis at contrast magnetic resonance imaging, suggesting persistent maladaptive remodeling. 52,53 A common cause of TIC is persistent atrial tachycardia or accessory pathway mediated supraventricular tachycardias.…”

Section: Reviewmentioning

confidence: 98%

Reversible Dilated Cardiomyopathy: Into the Thaumaturgy of the Heart—Part 1

et al. 2016

View full text Add to dashboard Cite

Dilated cardiomyopathy (DCM) is a genetic or acquired heart muscle disorder characterized by dilation and impaired contraction of one or both ventricles. In the acquired forms of the disease, if the pathogenic agent is persistent, undiagnosed or untreated, permanent ultrastructural and morphological changes may lead to irreversible dysfunction. Conversely, when DCM is promptly recognized and treated, the heart may show an extraordinary ability to recover from left ventricular (LV) systolic dysfunction. While much research in heart failure has focused on morbidity and mortality associated with persistent LV systolic dysfunction, relatively little attention has been devoted to this remarkable potential for recovery. In this two-part review we will focus on the most common types of reversible DCM. The first part will deal with Tako-Tsubo cardiomyopathy, tachycardiainduced cardiomyopathy, metabolic DCM and recovery after Left ventricular assist device implantation. Although diverse in etiopathogenesis, genetic background, therapeutic options and outcome, the forms of DCM characterized by reversible LV dysfunction share similar challenges in diagnosis and clinical management. The identification of pathways to recovery may show the way for novel therapeutic targets ultimately benefitting all cardiac patients.

show abstract

“…15 The duration of the PVCs is thought to be a determinant of LV dysfunction. PVCs with longer QRS duration seem to be associated with worsening LV function and in these patients ablation leads to LV improvement (17). Mechanisms proposed for PVC-mediated LV dysfunction include alterations in calcium homeostasis, increased oxygen consumption, and ventricular dyssynchrony.…”

Section: Pvc's Induced Cardiomyopathymentioning

confidence: 99%

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

Jazra¹,

Wazni²,

Jaroudi³

2015

ICFJ

View full text Add to dashboard Cite

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.

show abstract

Recovery from left ventricular dysfunction after ablation of frequent premature ventricular complexes

Cited by 139 publications

References 6 publications

The effect of radiofrequency catheter ablation of frequent premature ventricular complexes and arrhythmia burden on left ventricular function

The effect of radiofrequency catheter ablation of frequent premature ventricular complexes and arrhythmia burden on left ventricular function

Reversible Dilated Cardiomyopathy: Into the Thaumaturgy of the Heart—Part 1

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

Contact Info

Product

Resources

About