Key result
Frequent right ventricular outflow tract premature ventricular complexes (≥10,000/24 hours) were associated with a 34% prevalence of LV dysfunction compared to 4% with <1000/24 hours (P=0.02).
Why the study?
Is a higher burden of RVOT PVCs associated with an increased prevalence of LV dysfunction in patients without structural heart disease?
Observational (n=108)
Is a higher burden of RVOT PVCs associated with an increased prevalence of LV dysfunction in patients without structural heart disease?
Frequent RVOT PVCs, particularly a burden of >=10,000/24 hours, and non-sustained VT are significantly associated with LV dysfunction in patients without underlying structural heart disease.
Answers are grounded in this paper and cite their sources.
Frequent RVOT PVCs may indicate need for LV function assessment; leaves open whether burden reduction improves outcomes.
BACKGROUND: Recent case series have shown reversal of left ventricular (LV) dysfunction after catheter ablation of frequent premature ventricular complexes (PVCs) originating from the right ventricular outflow tract (RVOT). We conducted a retrospective study to evaluate the prevalence of patients with frequent RVOT PVCs (> or =10 per hour) and LV dysfunction. METHODS: RVOT PVC was defined as PVC with left bundle branch block morphology and inferior axis on a 12-lead ECG. We included patients with frequent RVOT PVCs on 24-hours Holter monitor who had a recent evaluation of LV function. Patients with structural heart disease, including obstructive coronary artery disease, were excluded. Patients were divided into three groups based on the number of PVCs (<1000/24 hour, 1000-10,000/24 hour, > or =10,000/24 hour), and the prevalence of LV dysfunction was evaluated in each group. RESULTS: Our analysis included 108 patients: 24 patients had <1000PVCs/24 hour, 55 patients had 1000-10,000PVCs/24 hour, and 29 patients had > or =10,000PVCs/24 hour. The prevalence of LV dysfunction was 4%, 12%, and 34%, respectively (P = 0.02). With logistic regression analysis, non-sustained ventricular tachycardia was an independent predictor of LV dysfunction with odds ratio of 3.6 (1.3-10.1). CONCLUSION: We demonstrated a significant association between frequent RVOT PVCs and LV dysfunction in patients without structural heart disease.
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Kanei et al. (2008) conducted an observational in Frequent premature ventricular complexes originating from the right ventricular outflow tract (n=108). Frequent RVOT PVCs (≥10,000/24 hour) vs. <1000 PVCs/24 hour was evaluated on Prevalence of left ventricular dysfunction (OR 3.6, 95% CI 1.3-10.1, p=0.02). Frequent right ventricular outflow tract premature ventricular complexes (≥10,000/24 hours) were associated with a 34% prevalence of LV dysfunction compared to 4% with <1000/24 hours (P=0.02).
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