Acute changes in left atrial appendage function with premature ventricular complexes

Area of Science:

• Cardiology
• Electrophysiology
• Stroke Prevention

Background:

• Left atrial appendage (LAA) dysfunction is a known risk factor for embolic stroke.
• Frequent premature ventricular complexes (PVCs) are also associated with an increased risk of stroke.

Purpose of the Study:

• To investigate whether left atrial dysfunction serves as a link between frequent PVCs and stroke.
• To assess the acute effect of simulated frequent PVCs on LAA function.

Main Methods:

• Ten patients with structurally normal hearts undergoing electrophysiology study were included.
• Transesophageal echocardiography measured LAA flow velocities.
• PVCs were simulated using right ventricular pacing in a bigeminal pattern for 5 minutes.

Main Results:

• A significant decrease in LAA late diastolic emptying velocity was observed after 5 minutes of simulated PVCs (p=0.01).
• LAA filling velocity showed a non-significant trend toward decrease.
• LAA velocities largely returned to baseline after a 5-minute rest period.

Conclusions:

• Simulated frequent PVCs in a bigeminal pattern acutely impair LAA diastolic emptying velocity.
• This acute LAA dysfunction represents a potential mechanism contributing to the increased stroke risk associated with frequent PVCs.