Search Results (7)

Background: Premature ventricular contractions (PVCs) are common arrhythmias associated with symptoms such as fatigue and, in severe cases, PVC-induced cardiomyopathy. Catheter ablation (CA) is a primary treatment for symptomatic PVCs, particularly when pharmacological therapies fail or are undesired. While improvements in: quality-of-life following ablation are documented, its impact on functional capacity remains underexplored. Objectives: This study evaluated the impact of CA on functional capacity and cardiac stress markers in patients with symptomatic PVCs using cardiopulmonary exercise testing (CPET) and NT-proBNP levels. Methods: A total of 30 patients underwent successful PVC ablation and completed baseline and follow-up CPET evaluations under the Bruce protocol. PVC burden, left ventricular ejection fraction (LVEF), NT-proBNP levels, and CPET parameters, including VO₂ max, METS, ventilatory efficiency, and anaerobic threshold (AT), were analyzed pre- and post-ablation. Results: PVC burden significantly decreased post-ablation (23,509.3 ± 10,700.47 to 1759 ± 1659.15, p < 0.001). CPET revealed improved functional capacity, with VO₂ max increasing from 24.97 ± 4.16 mL/kg/min to 26.02 ± 4.34 mL/kg/min (p = 0.0096) and METS from 7.16 ± 1.17 to 7.48 ± 1.24 (p = 0.0103). NT-proBNP significantly decreased (240.93 ± 156.54 pg/mL to 138.47 ± 152.91 pg/mL, p = 0.0065). LVEF and ventilatory efficiency metrics (VE/VO₂ and VE/VCO₂) remained stable. Conclusions: Catheter ablation improves functional capacity, reduces cardiac stress, and minimizes medication dependency in patients with symptomatic PVCs. These findings support the utility of ablation in enhancing aerobic capacity and overall exercise performance. Full article

Background: Frequent premature ventricular complexes (PVCs) are associated with adverse outcomes in patients with structural heart disease (SHD), including increased risk of mortality and impaired left ventricular ejection fraction (LVEF). While radiofrequency ablation (RFA) of idiopathic PVCs is well established, its role in patients with SHD remains less clear. Objective: To review the evidence on the efficacy of RFA for PVC suppression in patients with SHD, specifically evaluating its impact on LVEF and clinical outcomes. Methods: A review of the literature was conducted using PubMed and the Cochrane Library, focusing on studies published after 2010 that included adult patients with SHD and a PVC burden >4% on 24 h Holter monitoring. Studies including patients with presumed PVC-induced cardiomyopathy without underlying SHD were excluded. Key outcomes were LVEF recovery, functional status, and procedural success rates. Results: In ischemic cardiomyopathy, RFA reduced PVC burden significantly and resulted in modest but significant LVEF improvement. In non-ischemic cardiomyopathy, successful ablation improved LVEF by 8–12% on average and enhanced NYHA class. Across mixed cohorts, patients with sustained PVC suppression showed significant improvements in LVEF, functional status, which, in many cases, removed the indication for implantable cardioverter-defibrillators. Notably, procedural success rates ranged from 60 to 94%, and the high baseline PVC burden (>13–20%) consistently predicted LVEF recovery regardless of SHD etiology. Conclusions: RFA of frequent PVCs in patients with SHD leads to meaningful improvements in systolic function and symptoms, particularly in those with high PVC burden. These benefits are seen across ischemic and non-ischemic substrates, although procedural complexity and recurrence rates may be higher. PVC burden, rather than SHD presence alone, should guide patient selection for ablation. Full article

Background/Objectives: Persistent high Premature Ventricular Contraction (PVC) burden (>10%) may result in PVC-induced cardiomyopathy. Current guidelines, supported by limited evidence, recommend flecainide for PVCs originating from the ventricular outflow tract (Class IIa). UNIFLECA is a prospective cohort study, aiming to assess the efficacy and safety of flecainide in PVC burden reduction in adults, irrespective of PVC origin, focusing secondarily on symptom relief and improvement of left ventricular ejection fraction (LVEF) in patients suffering from PVC-induced cardiomyopathy. Methods: Participants were adults with frequent PVCs, defined as PVC burden > 5%, confirmed by two 24 h Holter recordings taken at least one month apart, who denied catheter ablation treatment. Patients who were deemed ineligible for catheter ablation were also included. A total of 50 patients were screened and 35 were administered Flecainide, with dosage adjustment based on follow-up Holter results and QRS increases. Changes in PVC burden, LVEF, symptomatic status, along with treatment adherence, were evaluated. Results: In adults with frequent PVCs, flecainide led to a significant reduction in PVC burden, with a mean decrease of 76.2% in the first month, and 63.1% of patients achieving a PVC burden reduction greater than 80%. Conclusions: UNIFLECA contributes to the understanding of how personalized, non-interventional therapeutic modalities can be employed to manage PVCs, especially for patients unwilling to have or ineligible for ablation procedures. Full article

Premature ventricular complexes (PVCs) are commonly encountered problems in clinical settings. The range of symptoms can be from asymptomatic to palpitations, fatigue, or heart failure symptoms. A higher burden of PVCs is a risk factor for development of PVC-induced cardiomyopathy (PIC). Rhythm evaluation by 12-lead ECG and an ambulatory monitoring device are essential. Currently, several imaging modalities, such as echocardiography and cardiac magnetic resonance imaging, are utilized to evaluate the underlying structure that may be related to PIC. Beta blockers and antiarrhythmic drugs are typically part of the initial management strategy. If these fail, catheter ablation of PVCs is typically the next step. The purpose of this article is to summarize the current evidence/knowledge about PIC. Full article

Background: Frequent premature ventricular complexes (PVCs) can cause PVC-induced cardiomyopathy. The value of PVC ablation in patients with preserved left ventricular function in the low–normal range (ejection fraction: 50–55%) is not established. Strain analysis has been used to estimate changes in left ventricular function beyond assessment of the ejection fraction (EF). Longitudinal strain has been proposed as a method to detect changes over time in the setting of frequent asymptomatic premature ventricular complexes and preserved left ventricular (LV) function. A decrease in strain may be evidence of PVC-induced cardiomyopathy. Objective: In this study, we assessed the role of PVC ablation in patients with low–normal EF and the effect on EF and myocardial strain before and after PVC ablation. Methods: A total of 70 consecutive patients with either low–normal EF (0.5–<0.55, n = 35) or high–normal EF (≥0.55; n = 35), using available imaging and Holter data, were referred for ablation due to frequent PVCs. EF and longitudinal strain were assessed pre- and post-ablation. Results: There was a significant increase in EF (53.2 ± 0.4% to 58.3 ± 0.5%, p < 0.001) and improvement in longitudinal strain (−15.2 ± 3.3 to −16.6 ± 3, p = 0.007) post-ablation in patients with low–normal EF and successful ablation. There was no change in EF or longitudinal strain in patients with high–normal EF and a successful ablation pre- vs. post-ablation. Conclusions: Patients with frequent PVCs and low–normal LV EF compared to patients with frequent PVCs and high–normal LV EF have evidence of PVC-induced cardiomyopathy and may benefit from ablation despite a preserved left ventricular EF. Full article

Premature ventricular contractions (PVCs) are common and generally benign in childhood and tend to resolve spontaneously in most cases. When PVCs occur frequently, an arrhythmia-induced cardiomyopathy may be present requiring medical or catheter ablation. PVCs are only rarely the manifestation of a cardiomyopathy. The purpose of this review is to provide some tips and tricks to raise the suspicion of a cardiac disease based on the presence and characteristics of PVCs in children. Full article

Background: Association of premature ventricular complexes (PVC) with left ventricular systolic dysfunction (LVSD) and efficacy of catheter ablation treatment have been demonstrated in studies. The role of left atrial (LA) mechanics in the etiopathogenesis of PVC-induced cardiomyopathy (PVC-CMP) as well as changes in LA mechanics with catheter ablation have not been studied before. Methods: A total number of 61 patients (Mean Age 43 ± 3) with idiopathic outflow tract (OT) PVCs undergoing radiofrequency catheter ablation (RFCA) were enrolled. ECG, 24 h Holter, and echocardiographic evaluation with left ventricular (LV) diastolic functions and LA volumetric assessments were performed before and three months after RFCA. Results: Along with a marginal increase in left ventricle ejection fraction (LVEF), improvement in diastolic functions and left atrial mechanics were observed in the study (LVEF 53 ± 7 versus 57 ± 6, p < 0.01) in short-term follow-up. The frequency of LV diastolic dysfunction (LVDD) decreased with catheter ablation (n = 5 to 0, p = 0.02). The overall LA function improved. Left atrium passive and overall emptying fraction (LAEF) increased significantly (0.32 ± 0.04 to 0.41 ± 0.04, p < 0.05 and 0.62 ± 0.04 to 0.65 ± 0.004, p < 0.05, respectively). Active LAEF decreased significantly (0.29 ± 0.005 to 0.24 ± 0.006, p < 0.05). Conclusions: The results of this study are indicative of “PVC-induced atriomyopathy” which responds to RFCA in short-term follow-up. Atrial dysfunction might play a role in symptoms and etiopathogenesis of LVSD. Full article