Tachycardiomyopathy Induced by Ventricular Premature Complexes: Complete Recovery after Radiofrequency Catheter Ablation

Abstract

Ventricular premature complexes (VPCs) are known to be one of the most benign cardiac arrhythmias when they occur in structurally normal hearts. We experienced a 32-year old man who presented with dyspnea, palpitations and very frequent VPCs (31% of the total heart beats). Echocardiography revealed a dilated left ventricle (LV 66 mm at end-diastole and 57 mm at end-systole) and a decreased ejection fraction (34%). Very frequent VPCs had been detected 10 years previously and he underwent a failed radiofrequency catheter ablation (RFCA) procedure at that time. The patient had been treated with heart failure medications including betablockers, ACE inhibitors and spironolactone for the two most recent years. Six months after we eliminated these VPCs with a second RFCA procedure, the heart returned to normal function and size. Long standing and very frequent VPCs could be the cause of left ventricular dysfunction in a subset of patients who suffer with dilated cardiomyopathy, and RFCA should be the choice of therapy for these patients.

Tachycardia-Mediated Cardiomyopathy Secondary to Focal Atrial Tachycardia

“…This overexpression of the renin-angiotensin system may account for an individual predisposition to develop cardiomyopathy in the context of incessant tachycardia in some patients. A high burden of ventricular ectopic activity has been shown to result in LV dysfunction (25). In the present study, 1 patient had impaired ventricular function in response to frequent or "incessant" atrial ectopy.…”

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

“…Catheter ablation should be considered as the first-line therapy in all patients with PVC > 20,000/day and LV dysfunction [24]. Still, there are many unclear aspects of tachycardiomyopathy treatment in the prevention of structural changes and long-term risk of sudden cardiac death, which necessitate further exploration [25,26].…”

Characteristics of Premature Ventricular Complexes as Correlates of Reduced Left Ventricular Systolic Function: Study of the Burden, Duration, Coupling Interval, Morphology and Site of Origin of PVCs

“…Premature ventricular complexes (PVCs) are among the most common cardiac arrhythmias encountered in clinical practice. There has been a recent accumulation of evidence implicating PVCs as a cause of reversible cardiomyopathy 1–15 . Many studies have reported the burden of PVCs as a proportion of all ventricular complexes to be a significant determinant of developing left ventricular (LV) systolic dysfunction.…”

“…There has been a recent accumulation of evidence implicating PVCs as a cause of reversible cardiomyopathy. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15] Many studies have reported the burden of PVCs as a proportion of all ventricular complexes to be a significant determinant of developing left ventricular (LV) systolic dysfunction. However, a clinically relevant cut-off that identifies an increased risk has not been established.…”