Frequent Premature Ventricular Complexes and Catheter Ablation for Atrial Fibrillation

Frequent premature ventricular complexes (PVCs) are often observed in patients undergoing ablation of atrial fibrillation (AF). However, the relationship between AF ablation and PVCs is uncertain. The purpose of this study was to examine the prevalence of frequent PVCs before and after catheter ablation of AF.

This was a retrospective cohort study of patients undergoing ablation of AF at two tertiary centers. All patients undergoing initial or repeat ablation of AF were eligible. Patients were followed in AF clinics before and after ablation with routine ambulatory ECG monitoring.

The cohort consisted of 421 patients (mean 63 years, 33% female, 57% paroxysmal). At baseline, 18.4% and 4.7% had ≥ 1% and ≥ 5% PVCs respectively. In the 179 days post-ablation, 9.0% developed new onset ≥ 1% PVCs, whereas 10.9% of patients had regression from ≥ 1% to < 1% PVCs. In the total follow up period of 2 years, there was a significant increase in the proportion of patients with ≥ 1% PVCs. Multivariable modeling revealed baseline PVC burden and hypertension as the only predictors of an increasing PVC burden in the post-ablation period.

Frequent PVCs are highly prevalent among patients undergoing AF ablation. However, there was no signal of an increase in frequent PVCs in the immediate post-ablation period.