Assessment of subtle cardiac dysfunction induced by premature ventricular contraction using two dimensional strain echocardiography and the effects of successful ablation

Background: We aimed to evaluate the effects of successful ablation on impaired left ventricular global longitudinal strain (LV-GLS) in patients with frequent premature ventricular contractions (PVCs). We also evaluated the potential risk factors of impaired LV-GLS. Methods: Thirty-six consecutive patients without any structural heart disease who were treated with radiofrequency (RF) ablation because of frequent PVCs were included into the study. All patients were evaluated with standard transthoracic and two-dimensional speckle tracking echocardiography (2D-STE). Results: The mean LVGLS values before ablation were 17.3±3.7. This value was observed as 20.5±2.6 after ablation and the difference was statistically significant (p<0.01). Patients were categorized into 2 groups in the form of those having LV-GLS value >-16% and ≤16%. Low PVC E flow/post-PVC E flow and PVC SV/post-PVC SV ratios were associated with impaired LV-GLS. Conclusion: In symptomatic patients with frequent PVCs and normal left ventricular ejection fraction (LVEF), we observed significant improvement in LV-GLS value following successful RF ablation. Patients with impaired LV-GLS more often display nonejecting PVCs and postextrasystolic potentiation (PEP) compared to patients with normal LV-GLS.