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Left ventricular remodeling in premature ventricular contraction-induced cardiomyopathy: Effect of coupling intervals

Pouria Shoureshi1,2, Rajiv Kabadi1, Nicholas James2

  • 1Department of Internal Medicine, Cardiology Division, Central Virginia VA Health Care System/McGuire Veterans Affairs Medical Center, Richmond, Virginia.

Heart Rhythm O2
|September 25, 2023
PubMed

Insights

Short-coupled and long-coupled premature ventricular contractions (PVCs) both contribute equally to PVC-induced cardiomyopathy (PVC-CM) through left ventricular dyssynchrony and postextrasystolic potentiation. Atrioventricular dissociation did not independently influence PVC-CM development.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Heart Failure Research

Background:

  • Premature ventricular contractions (PVCs) can lead to cardiomyopathy (PVC-CM).
  • Left ventricular dyssynchrony (LVD) and postextrasystolic potentiation (PESP) are implicated in PVC-CM development.
  • Long-coupled (LC) PVCs induce greater LVD, while short-coupled (SC) PVCs exhibit stronger PESP.

Purpose of the Study:

  • To compare SC-PVCs and LC-PVCs.
  • To evaluate the roles of LVD, PESP, and atrioventricular dissociation (AVD) in PVC-CM development.

Main Methods:

  • Canine model with induced bigeminal PVCs (50% burden) for 12 weeks.
  • Grouping into SC-PVC, LC-PVC, and sham control groups.
  • Monitoring of PVC burden, AVD, echocardiographic changes, and hemodynamics.

Main Results:

  • Both SC-PVC and LC-PVC groups showed significant decreases in left ventricular ejection fraction (LVEF) compared to sham.
  • PVC burden was similar between groups, but higher in SC-PVC.
  • No significant correlation found between AVD and LVEF reduction.

Conclusions:

  • Neither PVC coupling interval nor AVD independently determined PVC-CM severity.
  • LVD and PESP contribute equally to PVC-CM development.
  • This study elucidates the mechanisms of PVC-induced cardiomyopathy.
Abstract

Keywords:
Atrioventricular dissociationCardiomyopathyCoupled intervalHeart failureLeft ventricular remodelingPremature ventricular contractions

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