Effect of ablation of frequent premature ventricular complexes on left ventricular function in patients with...

Frequent idiopathic premature ventricular complexes (PVCs) can result in PVC-induced cardiomyopathy. Frequent PVCs can also aggravate ischemic cardiomyopathy.

The purpose of this study was to investigate the impact of frequent PVCs on nonischemic cardiomyopathy.

This was a consecutive series of 30 patients (mean age 59.1 ± 12.1; 18 men; mean ejection fraction [EF] 38% ± 15%) with structurally abnormal hearts based on the presence of scar on cardiac magnetic resonance imaging and/or a history of cardiomyopathy before the presence of frequent PVCs who were referred for ablation of frequent PVCs.

Ablation was successful in 18 of 30 patients (60%), resulting in an increase of mean EF from 33.9% ± 14.5% to 45.7% ± 17% (P < .0001) during mean follow-up of 30 ± 28 months. The PVC burden in these patients was reduced from 23.1% ± 8.8% to 1.0% ± 0.9% (P < .0001). Mean EF did not change in patients with a failed ablation procedure (44.4 ± 16 vs 43.5 ± 21, P = .85). The PVC site of origin was in scar tissue in 14 of 18 patients with a successful ablation procedure. Mean New York Heart Association functional class improved from 2.3 ± 0.6 to 1.1 ± 0.2 (P < .0001) in patients with a successful outcome and remained unchanged in patients with an unsuccessful outcome (1.9 ± 0.9 vs 1.9 ± 0.7, P = 1).

In patients with frequent PVCs and nonischemic cardiomyopathy, EF and functional class can be improved but not always normalized by successful PVC ablation. In most patients with an effective ablation, the arrhythmogenic substrate was located in scar tissue.