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RESEARCH PRODUCT

The effect of radiofrequency catheter ablation of frequent premature ventricular complexes and arrhythmia burden on left ventricular function

Grzegorz HordyńskiAgnieszka Wojdyła-hordyńskaBorislav DinovGerhard HindricksArash AryaPiotr FeusetteOskar KowalskiPhilipp Sommer

subject

AdultMalemedicine.medical_specialtyHeart diseasemedicine.medical_treatmentCardiomyopathyCatheter ablation030204 cardiovascular system & hematologyVentricular Dysfunction Left03 medical and health sciencesQRS complex0302 clinical medicineInternal medicinemedicineHumanscardiovascular diseases030212 general & internal medicineventricular arrhythmiaAgedEjection fractionbusiness.industryleft ventricular ejection fractionStroke VolumeStroke volumeMiddle Agedmedicine.diseaseAblationstructural heart diseaseVentricular Premature ComplexesTreatment OutcomeEchocardiographyConcomitantMultivariate AnalysisCatheter Ablationcardiovascular systemCardiologyFemalepremature ventricular complexCardiology and Cardiovascular Medicinebusiness

description

Background: Frequent premature ventricular complexes (PVC) are related to reversible tachycardia-induced cardiomyopathy. However, the role of arrhythmia burden on the outcome of the catheter ablation has not been fully recognised. Aim: The aim of this study was to assess the effect of catheter ablation and PVC burden in patients with and without structural heart disease (SHD) on left ventricular ejection fraction (LVEF). Methods: Transthoracic echocardiography was done before and six months after radiofrequency catheter ablation in 109 consecutive patients (61 men, age 55 ± 17 years) with frequent PVCs. Sixty-five (59.6%) patients had underlying SHD. Results: The catheter ablation procedure was successful in 93 (85.3%) patients. Baseline PVC burden was higher in patients with SHD (22,267 ± 12,934) compared to those without concomitant SHD (15,546 ± 7888), p = 0.005. Nevertheless, patients with LVEF ≤ 50% at baseline presented greater LVEF recovery (from 44% to 56%) than those with LVEF > 50% at baseline after catheter ablation. In both groups, the LVEF improved (p 20,000/day (but not age, p = 0.95; gender, p = 0.89; presence of SHD, p = 0.53; QRS complex width of the treated PVC, p = 0.21, LVEF before ablation, p = 0.19; and site of origin, p = 47) predicted improvement in LVEF after successful catheter ablation (odds ratio: 3.53; 95% confidence interval: 1.15–10.75; p = 0.023). Conclusions: Catheter ablation of frequent PVCs improves left ventricular function in multivariate analysis predicted improvement of LVEF within six months after the successful catheter ablation procedure in patients with PVC burden exceeding 20,000/24 h.

https://doi.org/10.5603/kp.a2017.0058