Advances in management of premature ventricular contractions.

Abstract

Premature ventricular complexes (PVCs) are a common occurrence in clinical practice. The clinical presentation may range from asymptomatic to left ventricular (LV) dysfunction with congestive heart failure. The decision to suppress PVCs is largely based on the presence of symptoms, interference with other therapy (e.g., cardiac resynchronization therapy), or suspicion of PVC-mediated cardiomyopathy. Catheter ablation has emerged as a safe and effective option for the treatment of frequent PVCs. Careful attention to PVC characteristics on surface electrocardiogram has proven useful for the initial localization of the ectopic focus, which may then serve as a guide to procedural planning. The point of interest is often identified with activation mapping, and the ablation site can be further defined with pace mapping techniques. Clinical experience with PVC ablation has been successful in ≥80 % of cases, and the literature reports multiple cases of marked improvement in LV function after eradicating the culprit ectopic focus in patients with PVC-mediated cardiomyopathy.

• Authors: Jonathon C Adams, Komandoor Srivathsan, Win K Shen
• Journal: Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing (J Interv Card Electrophysiol) Vol. 35 Issue 2 Pg. 137-49 (Nov 2012) ISSN: 1572-8595 [Electronic] Netherlands
• PMID: 22875587 (Publication Type: Journal Article, Review)

Topics

• Cardiomyopathies (physiopathology, surgery)
• Catheter Ablation (methods)
• Echocardiography
• Electrocardiography
• Humans
• Ventricular Dysfunction, Left (physiopathology, surgery)
• Ventricular Premature Complexes (physiopathology, surgery)