Recurrence of PVCs in patients with PVC-induced cardiomyopathy.

Autor:	Baser K; Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, Michigan., Bas HD; Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, Michigan., LaBounty T; Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, Michigan., Yokokawa M; Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, Michigan., Good E; Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, Michigan., Latchamsetty R; Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, Michigan., Morady F; Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, Michigan., Bogun F; Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, Michigan. Electronic address: fbogun@med.umich.edu.
Jazyk:	angličtina
Zdroj:	Heart rhythm [Heart Rhythm] 2015 Jul; Vol. 12 (7), pp. 1519-23. Date of Electronic Publication: 2015 Mar 16.
DOI:	10.1016/j.hrthm.2015.03.027
Abstrakt:	Background: The natural history of premature ventricular complex (PVC)-induced cardiomyopathy is incompletely understood. Objective: The purpose of this study was to assess long term follow-up data in patients who underwent successful PVC ablation for PVC-induced cardiomyopathy. Methods: The subjects of this study were 60 patients (17 women; mean age 52.5 ± 16.8 years; ejection fraction [EF] 37.3 ± 8.5%, median 40%, interquartile range [IQR] 15) with PVC-induced cardiomyopathy who underwent successful ablation of their predominant PVCs between 2005 and 2012. Patients were followed up for a mean of 23.6 ± 17.2 months. EF improved to 57.2 ± 4.7% (median 55%, IQR 5; P = .0001) within 9.6 ± 8.4 months of the ablation procedure. During follow-up, 10 of 60 patients (16.7%) had recurrent frequent PVCs and 50 patients (83.3%) did not. Patients underwent repeat assessment of EF and PVC burden. Results: During follow-up of 23.6 ± 17.2 months, 10 patients had recurrent frequent PVCs, with an increase of their PVC burden from 1.4 ± 0.9% (median 1.05%, IQR 1.59) after the initial ablation to 27.2 ± 8.8% (median 26.0%, IQR 18.2; P = .018). Their EF decreased from 55.7 ± 3.4% (median 55%, IQR 5.8) after the initial ablation to 40.2 ± 5.1% (median 40%, IQR 15; P = .005). In the remaining patients with PVC-induced cardiomyopathy, EF and PVC burden remained unchanged during follow-up. Patients with PVC recurrence had a higher number of pleomorphic PVC morphologies during initial presentation (4.7 ± 2.2 vs 2.5 ± 2.8, P = .002). Conclusion: Recurrence of frequent PVCs in patients with a history of PVC cardiomyopathy can result in recurrence of cardiomyopathy. Follow-up in patients with PVC-induced cardiomyopathy is important, especially if patients were asymptomatic from the PVCs and have pleomorphic PVCs. (Copyright © 2015 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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