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A case of premature ventricular contractions-related cardiomyopathy

Enoch Chung1, Sara Young2, Michael A Chen3

  • 1Boston University School of Medicine, Boston, Massachusetts, USA.

The Journal of the Royal College of Physicians of Edinburgh
|September 16, 2021
PubMed

Insights

Premature ventricular contractions (PVCs) can cause cardiomyopathy. Successful PVC ablation restored normal heart function and structure in a patient with severe symptoms.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Cardiac Imaging

Background:

  • Premature ventricular contractions (PVCs) are ectopic heartbeats originating in the ventricles.
  • A high burden of PVCs is increasingly recognized as a cause of ventricular dysfunction and cardiomyopathy.
  • Early identification and management are crucial for preventing adverse cardiac remodeling.

Observation:

  • A 65-year-old male presented with chest pain and dizziness, later found to have a high PVC burden (32%) on Holter monitoring.
  • Initial echocardiography revealed mild left ventricular (LV) hypertrophy and reduced LV ejection fraction (43%), along with mild right ventricular (RV) dysfunction.
  • Medical management with beta-blockers and ACE inhibitors did not improve PVC burden or cardiac function.

Findings:

  • The patient underwent successful radiofrequency catheter ablation to eliminate the PVCs.
  • Post-ablation, PVC burden decreased significantly (<1%) as confirmed by Holter monitoring.
  • Repeat echocardiography demonstrated normalization of LV systolic function and resolution of RV dysfunction.

Implications:

  • This case highlights the efficacy of PVC ablation in reversing PVC-related cardiomyopathy.
  • Catheter ablation should be considered for patients with significant PVC burden and resulting cardiac dysfunction.
  • Successful ablation can lead to significant improvement in heart function and resolution of symptoms.

Keywords:
ablationcardiomyopathyheart failurepremature ventricular complexespremature ventricular contractions

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