Do specific clinical and electrocardiographic risk factors predict the development of PVC-induced cardiomyopathy and the reversibility of left ventricular systolic dysfunction after ablation in patients with frequent PVCs?
Asymptomatic status, interpolated PVCs, and epicardial origin are independent risk factors for developing PVC-induced cardiomyopathy, while narrower sinus QRS duration and higher PVC burden predict LVSD reversibility after ablation.
Background: Premature ventricular complex (PVC) induced cardiomyopathy (PVC-CMP) and exacerbated left ventricular systolic dysfunction (LVSD) are common in clinical scenarios. However, their precise risk factors are currently unclear. Methods: We performed a systematic review of PubMed, EMBASE, Web of Science, and Chinese-based literature database (CBM) to identify observational studies describing the factors associated with PVC-CMP and post-ablation LVSD reversibility. A total of 25 and 12 studies, involving 4863 and 884 subjects, respectively, were eligible. We calculated pooled multifactorial odds ratios (OR) and 95% confidence intervals (CI) for each parameter using random-effects and fixed-effects models. Results: The results showed that 3 independent risk factors were associated with PVC-CMP: being asymptomatic (OR and 95% CI: 3.04 2.13, 4.34), interpolation (OR and 95% CI: 2.47 1.25, 4.92), and epicardial origin (epi-origin) (OR and 95% CI: 3.04 2.13, 4.34). Additionally, 2 factors were significantly correlated with post-ablation LVSD reversibility: sinus QRS wave duration (QRSd) (OR and 95% CI: 0.95 0.93, 0.97) and PVC burden (OR and 95% CI: 1.09 0.97, 1.23). Conclusions: the relatively consistent independent risk factors for PVC-CMP and post-ablation LVSD reversibility are asymptomatic status, interpolation, epicardial origin, PVC burden, and sinus QRS duration, respectively.
Zhao et al. (Wed,) studied this question.