Abstract | OBJECTIVES: This study aimed to assess the benefit after ablation of premature ventricular complexes ( PVC) in patients with frequent PVC and left ventricular ( LV) dysfunction, regardless of previous structural heart disease (SHD) diagnosis, PVC morphology, or estimated site of origin. BACKGROUND: METHODS: Consecutive patients with frequent PVC and LV dysfunction accepted for ablation at 4 centers were prospectively included. Of the 80 patients included, 27 (34%) had a diagnosis of SHD. RESULTS: Successful sustained ablation (SSA) was achieved in 53 (66%) patients, and LVEF improved in these patients from 33.7 ± 8% to 43.8 ± 9.4% and 45.8 ± 10.9% at 6 and 12 months, respectively (p < 0.05), without differences related to previous diagnosis of SHD (p = 0.69). BNP decreased from 109 [64 to 242] pg/ml to 60 [25 to 170] pg/ml, 50 [14 to 130] pg/ml, and 60 [19 to 81] pg/ml at 1, 6, and 12 months (p < 0.05). Patients in NYHA class I increased from 12 (23%) to 42 (79%) at 12 months (p < 0.05). A 13% baseline PVC burden had 100% sensitivity and 85% specificity to predict an absolute increase ≥ 5% in LVEF after SSA. Although 20 patients with >13% PVC and SSA had class I indication for cardioverter defibrillator implantation, these indications were absent at 6 months post-ablation. CONCLUSIONS: Independently of the presence of SHD, the SSA of frequent PVC in patients with depressed LVEF induced a progressive clinical and functional improvement. Improvement in heart failure parameters was related to baseline PVC burden and persistence of ablation success.
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Authors | Diego Penela, Carine Van Huls Van Taxis, Carine Van Huls Vans Taxis, Luis Aguinaga, Juan Fernández-Armenta, Lluis Mont, Maria Angels Castel, Magda Heras, Jose María Tolosana, Marta Sitges, Augusto Ordóñez, Josep Brugada, Katja Zeppenfeld, Antonio Berruezo |
Journal | Journal of the American College of Cardiology
(J Am Coll Cardiol)
Vol. 62
Issue 13
Pg. 1195-202
(09 24 2013)
ISSN: 1558-3597 [Electronic] United States |
PMID | 23850913
(Publication Type: Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)
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Copyright | Copyright © 2013 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. |
Chemical References |
- Natriuretic Peptide, Brain
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Topics |
- Adult
- Aged
- Catheter Ablation
- Echocardiography
- Female
- Humans
- Magnetic Resonance Imaging
- Male
- Middle Aged
- Natriuretic Peptide, Brain
(blood)
- Prospective Studies
- Recovery of Function
- Stroke Volume
- Treatment Failure
- Ventricular Dysfunction, Left
(blood, complications, surgery)
- Ventricular Premature Complexes
(blood, complications, surgery)
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