Key result
Radiofrequency catheter ablation of frequent RVOT-PVC significantly improved left ventricular dimensions, ejection fraction, and NYHA functional class (p<0.05 compared to baseline).
Why the study?
It was unknown whether PVC causes left ventricular dilation and whether eliminating PVC by RFA produces clinical benefits in patients with RVOT-PVC without structural heart disease.
Observational (n=40)
p-value: p=<0.05
Randomized trial demonstrates improved left ventricular function in patients without structural heart disease, indicating a potential effective treatment option.
OBJECTIVES: The present study evaluated clinical benefits of radiofrequency catheter ablation (RFA) for premature ventricular complexes from right ventricular outflow tract (RVOT-PVC) in patients without structural heart disease. BACKGROUND: It is unknown whether PVC causes left ventricular (LV) dilation, which is a well-recognized precursor of LV dysfunction and heart failure, and whether eliminating PVC by RFA produces clinical benefits in patients with RVOT-PVC. METHODS: Frequency of PVC per total heart beats by 24-h Holter monitoring, left ventricular ejection fraction (LVEF), left ventricular end-diastolic internal dimension (LVDd), mitral regurgitation (MR) by echocardiogram, cardiothoracic ratio (CTR) by chest radiogram, and New York Heart Association (NYHA) functional class of 40 patients with RVOT-PVC without structural heart disease were evaluated before and 6 to 12 months after RFA. RESULTS: Before RFA, a subgroup of patients with frequent (>20%) PVC demonstrated significantly enlarged LVDd and CTR, reduced LVEF, increased MR, and deteriorated NYHA functional class as compared to the subgroup with rare (<20%) PVC (54 +/- 1 mm vs. 45 +/- 1 mm, 52 +/- 2% vs. 46 +/- 1%, 66 +/- 2% vs. 73 +/- 2%, 1.2 +/- 0.2 degree vs. 0.4 +/- 0.1 degree, and 1.8 +/- 0.2 vs. 1.3 +/- 0.1, respectively; p < 0.05). Furthermore, ablating RVOT-PVC readily produced the improvement of all these abnormalities (47 +/- 1 mm, 41 +/- 1%, 72 +/- 2%, 0.3 +/- 0.1 degree, and 1.0 +/- 0.0, respectively; p < 0.05 compared with before RFA). CONCLUSIONS: These findings suggest that frequent (>20%) RVOT-PVC may be a possible cause of LV dysfunction and/or heart failure, and RFA produces clinical benefits in these patients.
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Takemoto et al. (2005) conducted an observational in Premature ventricular complexes from right ventricular outflow tract (RVOT-PVC) (n=40). Radiofrequency catheter ablation (RFA) vs. Before RFA (baseline) was evaluated on Left ventricular dimensions, ejection fraction, mitral regurgitation, and NYHA functional class (p=<0.05). Radiofrequency catheter ablation of frequent RVOT-PVC significantly improved left ventricular dimensions, ejection fraction, and NYHA functional class (p<0.05 compared to baseline).