Ventricular Ectopy in Patients With Left Ventricular Dysfunction: Should It Be Treated?

Beneficial effects of catheter ablation of frequent premature ventricular complexes on left ventricular function

“…The underlying mechanism of PVC-associated LV dysfunction is still unclear. Ventricular desynchronisation produced by PVCs might be particularly important because it would affect ventricular depolarisation and repolarisation, and lead to ventricular adverse remodelling 4. A large burden of PVCs (up to 24%) is the independent prediction factor of worsened LV function25; however, as low as a 10% PVC burden was also reported to be associated with LV dysfunction 8.…”

“…Although the majority of PVCs are associated with a benign course away from arrhythmic sudden death,2 growing evidence suggests that PVCs might be associated with LV dysfunction and dilation, especially in patients with large PVC burden 3. Previous studies indicated that elimination of PVCs by catheter ablation might reverse PVC-associated LV dysfunction 4. However, relatively small sample sizes and inconsistent findings of these studies prevented us from determining to what extent cardiac function might be improved by catheter ablation of frequent PVCs.…”

Characteristics of Unselected High‐Burden Premature Ventricular Contraction Patients

“…It has long been known that PVCs may lead to worse prognosis after myocardial infarction, particularly in the setting of reduced systolic function, but studies have not previously focused on high‐burden PVCs in a more general, or less select, population . Therefore, when confronted with a high‐burden PVC patient for the first time in clinic, it remains difficult to counsel patients regarding their future risk of developing HF and the best strategies to mitigate that risk …”

Beneficial Effect of Renal Denervation on Ventricular Premature Complex Induced Cardiomyopathy

“…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.…”