Burden of Premature Ventricular Complexes and Risk of Cardiomyopathy: A Cross-Sectional Study

The association between premature ventricular complexes (PVCs) and ventricular function has been described in several observational studies, where it has been implied that a higher burden of PVCs plays a causative role in reducing left ventricular ejection fraction (LVEF). To date, however, few studies have examined the association of PVCs and cardiomyopathy on a population level.

In this treatment-agnostic, cross-sectional study, the authors examined the association of PVC burden with depressed LVEF.

We performed an analysis of >30,000 ambulatory monitors obtained on patients from April 22, 2017, and February 20, 2023. Subjects with ≥24 hours of monitoring, a PVC burden of ≥5%, and a transthoracic echocardiogram performed within 3 months of monitoring were included. The presence of cardiomyopathy was defined as LVEF <50%. Clinical factors including comorbidities and relevant medications were included and adjusted for.

The included sample included a total of 1,451 patients, with age 68.2 ± 14.5 years, female sex in 39.6%. The average PVC burden was 12.4% ± 7.4% (5%-43.4%). Of 746 subjects with a transthoracic echocardiogram, the mean LVEF was 55.6% ± 9.2% (25%-76.8%), with 171 subjects (22.9%) having an LVEF <50%. In both unadjusted and adjusted analyses, we found no significant association between percentage of PVCs and LVEF (P = 0.78), nor with PVC burden and depressed left ventricular function (P = 0.13).

We found no evidence that the PVC burden alone is an independent predictor of cardiomyopathy.