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Relationship between burden of premature ventricular complexes and left ventricular function

Timir S Baman1, Dave C Lange, Karl J Ilg

  • 1Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, Michigan, USA.

Heart Rhythm
|March 30, 2010
PubMed

Insights

A high burden of frequent premature ventricular complexes (PVCs) can lead to PVC-induced cardiomyopathy. A PVC burden exceeding 24% is independently associated with this condition.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Cardiomyopathy Research

Background:

  • Frequent idiopathic premature ventricular complexes (PVCs) can cause reversible left ventricular dysfunction.
  • The specific factors and critical burden of PVCs leading to impaired left ventricular function remain unclear.
  • The potential for a critical PVC burden to induce cardiomyopathy has not been definitively established.

Purpose of the Study:

  • To identify a threshold PVC burden associated with the development of PVC-induced cardiomyopathy.
  • To establish a cutoff value for PVC burden that predicts impaired left ventricular function.

Main Methods:

  • A cohort of 174 patients undergoing ablation for frequent idiopathic PVCs was studied.
  • 24-hour Holter monitoring assessed PVC burden, and transthoracic echocardiograms evaluated left ventricular function.
  • Receiver-operator characteristic curves were used to determine the cutoff PVC burden for left ventricular dysfunction.

Main Results:

  • 33% of patients (57/174) exhibited reduced left ventricular ejection fraction.
  • Patients with impaired ejection fraction had a mean PVC burden of 33% ± 13%, versus 13% ± 12% in those with normal function (P <.0001).
  • A PVC burden >24% demonstrated high sensitivity (79%) and specificity (78%) for identifying impaired left ventricular function, with an AUC of 0.89. The lowest burden linked to reversible cardiomyopathy was 10%.

Conclusions:

  • A PVC burden exceeding 24% is independently associated with PVC-induced cardiomyopathy.
  • This finding provides a critical threshold for monitoring and intervention in patients with frequent PVCs.
Abstract

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