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Insight of electrocardiographic and electrophysiological parameters on the left ventricular function in patients with

Ming-Jen Kuo1,2,3, Chin-Yu Lin1,2, Yenn-Jiang Lin1,2

  • 1Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.

Journal of Cardiovascular Electrophysiology
|April 16, 2023
PubMed

Insights

Ventricular arrhythmias originating from the left ventricular summit can cause left ventricular dysfunction. Catheter ablation improves function, with narrower QRS duration and better ejection fraction predicting recovery.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Heart Failure Research

Background:

  • Ventricular arrhythmias (VA) frequently originate from the left ventricular summit (LVS).
  • Left ventricular (LV) dysfunction can occur in patients with LVS VA, but the underlying factors are not fully understood.
  • Understanding these factors is crucial for improving patient outcomes.

Purpose of the Study:

  • To investigate the risk factors associated with LV cardiomyopathy in patients with LVS VA.
  • To evaluate the clinical outcomes of patients undergoing catheter ablation for LVS VA.
  • To identify predictors of LV function recovery after ablation.

Main Methods:

  • A retrospective analysis of 139 patients who underwent catheter ablation for LVS VA between 2013 and 2018.
  • Detailed assessment of patient demographics, electrocardiograms, and electrophysiological characteristics.
  • Definition of LV cardiomyopathy as left ventricular ejection fraction (LVEF) <50%.

Main Results:

  • Acute procedural success was achieved in 92.8% of patients.
  • 40 patients (28.8%) had LV cardiomyopathy, with a mean LVEF improving significantly after ablation (37.5% to 48.5%).
  • Wider QRS duration and absolute earliest activation time discrepancy (AEAD) were independent factors for LV dysfunction; wider premature ventricular complex (PVC) QRS duration and lower LVEF predicted poor recovery.

Conclusions:

  • Wider PVC QRS duration and AEAD are associated with LV systolic dysfunction in LVS VA.
  • Catheter ablation can reverse LV remodeling and improve function.
  • Narrower QRS duration and higher LVEF predict better LV function recovery post-ablation.
Abstract

Keywords:
QRS durationablationabsolute earliest activation time discrepancyleft ventricular functionleft ventricular summitventricular arrhythmia

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