Key result
AF catheter ablation linked to ~11% regression of frequent PVCs alongside ~9% new-onset cases.
Why the study?
Frequent premature ventricular complexes are often observed in patients undergoing AF ablation, but the relationship between AF ablation and PVCs was uncertain.
Does catheter ablation of atrial fibrillation affect the prevalence of frequent premature ventricular complexes in patients with atrial fibrillation?
Cohort (n=421)
Yes
Does catheter ablation of atrial fibrillation affect the prevalence of frequent premature ventricular complexes in patients with atrial fibrillation?
Absolute Event Rate: 9% vs 18.4%
Frequent premature ventricular complexes are highly prevalent among patients undergoing atrial fibrillation ablation, and while catheter ablation does not trigger an immediate post-procedural increase, PVC burden increases over 2 years primarily driven by baseline PVC burden and hypertension.
Frequent PVCs predate AF ablation without consistent post-procedure rise in this cohort; leaves open shared substrate versus causal links, warranting prospective studies.
Background and Aims Frequent premature ventricular complexes (PVCs) are often observed in patients undergoing ablation of atrial fibrillation (AF). However, the relationship between AF ablation and PVCs is uncertain. The purpose of this study was to examine the prevalence of frequent PVCs before and after catheter ablation of AF. Methods This was a retrospective cohort study of patients undergoing ablation of AF at two tertiary centers. All patients undergoing initial or repeat ablation of AF were eligible. Patients were followed in AF clinics before and after ablation with routine ambulatory ECG monitoring. Results The cohort consisted of 421 patients (mean 63 years, 33% female, 57% paroxysmal). At baseline, 18.4% and 4.7% had ≥ 1% and ≥ 5% PVCs respectively. In the 179 days post‐ablation, 9.0% developed new onset ≥ 1% PVCs, whereas 10.9% of patients had regression from ≥ 1% to < 1% PVCs. In the total follow up period of 2 years, there was a significant increase in the proportion of patients with ≥ 1% PVCs. Multivariable modeling revealed baseline PVC burden and hypertension as the only predictors of an increasing PVC burden in the post‐ablation period. Conclusion Frequent PVCs are highly prevalent among patients undergoing AF ablation. However, there was no signal of an increase in frequent PVCs in the immediate post‐ablation period.
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Alshakhs et al. (2026) conducted a cohort in Atrial fibrillation with premature ventricular complexes (n=421). Catheter ablation of atrial fibrillation vs. Baseline pre-ablation status was evaluated on Prevalence of frequent premature ventricular complexes (≥ 1% PVCs). Catheter ablation for AF was associated with 9.0% new-onset ≥1% PVCs and 10.9% regression to <1% PVCs within 179 days (18.4% had ≥1% PVCs at baseline).
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