Key result
Successful PVC ablation links to a ~12% LVEF increase regardless of structural heart disease.
Why the study?
PVC ablation in patients with LV dysfunction is usually restricted to suspected PVC-induced cardiomyopathy, leaving its benefit uncertain regardless of structural heart disease diagnosis, PVC morphology, or site of origin.
Does PVC ablation improve LVEF, BNP, and NYHA class in patients with frequent PVCs and depressed LVEF, regardless of underlying structural heart disease?
Population
80 consecutive patients with frequent PVC and LV dysfunction across 4 centers
Comparison
PVC ablation evaluated across structural heart disease status
Design
Prospective multicenter cohort study
Follow-up
12 months
Authors
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Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
“If you have a patient with frequent premature ventricular complex and primary prevention ICD indication you must first ablate, withhold the ICD implant and re-evaluate the implantation during the first to sixth month post ablation. This seems to be an appropriate and safe strategy.”
“This paper was very intriguing because it suggested that catheter ablation for frequent premature ventricular complex will improve the ejection fraction to a degree that an ICD is not needed. We all know that implantation of an ICD is also associated with potential long-term issues, especially with leads. This strategy could also potentially cut costs. Therefore, if we can avoid ICD implant with a one-time ablation procedure there is an important clinical impact for the future.”
May support PVC ablation to improve LVEF in low-EF patients irrespective of structural heart disease; leaves open causal effects pending randomized trials.
Cohort (n=80)
Yes
Does PVC ablation improve LVEF, BNP, and NYHA class in patients with frequent PVCs and depressed LVEF, regardless of underlying structural heart disease?
p-value: p=<0.05
Successful ablation of frequent PVCs in patients with depressed LVEF significantly improves LVEF, BNP, and NYHA class, regardless of the presence of underlying structural heart disease.
Penela et al. (2013) conducted a cohort in Frequent premature ventricular complexes and left ventricular dysfunction (n=80). Premature ventricular complex ablation was evaluated on Left ventricular ejection fraction (LVEF) at 12 months (p=<0.05). Successful sustained ablation of frequent PVCs in patients with depressed LVEF increased LVEF from 33.7% to 45.8% at 12 months (p<0.05), independent of structural heart disease status.
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