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Premature ventricular contraction-induced cardiomyopathy

Lee, Andrea K.Y.; Deyell, Marc W.

Current Opinion in Cardiology: January 2016 - Volume 31 - Issue 1 - p 1–10
doi: 10.1097/HCO.0000000000000236
ARRHYTHMIAS: Edited by David H. Birnie
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Purpose of review There has been a resurgent interest in frequent premature ventricular contractions (PVCs) led by the novel concept that they may be a potential cause of, or at least contribute to, cardiomyopathy. This review evaluates recent advances in our understanding of PVC-induced cardiomyopathy.

Recent findings Recent studies have focused on identifying the predictors of PVC-induced cardiomyopathy, with the most consistent predictors being PVC burden and PVC QRS duration. Multiple studies have investigated the effect of catheter ablation on PVC burden and resultant left ventricular function, with the efficacy of catheter ablation and the overall PVC response rates varying between 60 and 88%. After successful ablation, the rates of improvement in left ventricular ejection fraction have varied between 47 and 100%. A recent study raises the question that perhaps even a lower PVC burden could result in PVC cardiomyopathy and adverse outcomes.

Summary There is an increasing body of literature supporting a causal role of frequent PVCs in the development of left ventricular dysfunction. Effective therapy for PVCs exists; however, the optimal indications for therapy have yet to be determined.

Heart Rhythm Services, Department of Medicine, Division of Cardiology, University of British Columbia, Vancouver, British Columbia, Canada

Correspondence to Marc W. Deyell, Heart Rhythm Services, St Paul's Hospital, #211-1033 Davie Street, Vancouver, BC, V6E 1M7, Canada. Tel: +1 604 806 8256; fax: +1 604 806 8723; e-mail: mdeyell@providencehealth.bc.ca

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