Outflow Tract Premature Ventricular Complex Induced Cardiomyopathy: A Narrative Review

Frequent premature ventricular complexes (PVCs) are well known to impair left ventricular systolic function. However, most patients with frequent PVCs do not develop cardiomyopathy. We review the various predictors and mechanisms of PVCs that lead to cardiomyopathy, with an emphasis on right ventricular outflow tract PVC-induced left ventricular dyssynchrony and diastolic dysfunction. The variable myocardial susceptibility to PVCs may be due to an undiagnosed subclinical cardiomyopathy. Advanced imaging modalities and genetic screening may help identify primary cardiomyopathic processes. Radiofrequency ablation to reduce PVC burden can not only improve both systolic and diastolic function but also reverse left ventricular remodeling and enhance quality of life.