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A New Combined Parameter to Predict Premature Ventricular Complexes Induced Cardiomyopathy: Impact and Recognition of

David Hamon1,2, Marie Sadron Blaye-Felice3, Jason S Bradfield2

  • 1Federation de Cardiologie, Hôpital Henri Mondor, Assistance Publique Hôpitaux de Paris and INSERM U955, Créteil, France.

Journal of Cardiovascular Electrophysiology
|March 1, 2016
PubMed

Insights

A new index combining PVC burden, QRS width, and epicardial origin best predicts premature ventricular complexes-induced cardiomyopathy (PVC-CMP). This index is crucial for identifying patients at risk, especially those with structural heart disease or epicardial PVCs.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Cardiac Imaging and Intervention

Background:

  • Premature ventricular complexes-induced cardiomyopathy (PVC-CMP) is a reversible condition influenced by multiple factors.
  • Predictors like PVC burden or QRS duration may not be universally applicable, particularly in patients with structural heart disease (SHD) or epicardial (EPI) PVC origins.
  • Accurate identification of PVC-CMP risk factors is essential for timely intervention.

Purpose of the Study:

  • To evaluate clinical criteria associated with PVC-CMP, focusing on the impact of EPI PVC origin and ECG recognition.
  • To assess the value of a new composite predictor, the PVC-CMP-Index, for identifying PVC-CMP.
  • To determine independent predictors of PVC-CMP in a contemporary patient cohort.

Main Methods:

  • A study of 107 consecutive patients referred for PVC ablation was conducted.
  • Patients were analyzed for PVC burden, QRS duration, presence of SHD, and PVC origin (epicardial vs. endocardial).
  • A novel PVC-CMP-Index was developed, incorporating PVC burden, QRS width, and indicators of SHD or EPI origin.

Main Results:

  • PVC-CMP prevalence was significantly higher in patients with EPI PVC origin (84.0%) compared to endocardial origin (45.1%).
  • Both EPI PVC origin (OR = 68.7) and SHD (OR = 12.3) were independent predictors of PVC-CMP.
  • The PVC-CMP-Index demonstrated high accuracy (AUC = 0.91) in predicting PVC-CMP, with 93% sensitivity and 80% specificity.

Conclusions:

  • Epicardial PVC origin and structural heart disease are significant independent predictors of PVC-CMP.
  • The developed PVC-CMP-Index, integrating PVC burden, QRS width, and EPI/SHD indicators, is a superior predictor of PVC-CMP.
  • This new index offers a valuable tool for risk stratification and management of patients with frequent PVCs.
Abstract

Keywords:
ECG criteriacatheter ablationcoronary sinusepicardialinduced cardiomyopathypremature ventricular complexes

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