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Frequent idiopathic premature ventricular complexes (PVCs) can result in a reversible form of cardiomyopathy. In this study, the determinants of PVC-induced left ventricular (LV) dysfunction were assessed. The subjects of this study were 241 consecutive patients (115 men [48%], mean age 48 ± 14 years) referred for ablation of frequent PVCs. One hundred eighty patients (75%) experienced palpitations and 61 (25%) did not. The PVC burden was determined by 24-hour Holter monitoring, and echocardiograms were performed to assess LV function. An LV ejection fraction of <50% was considered abnormal. LV ejection fraction (mean 0.36 ± 0.09) was present in 76 of 241 patients (32%). There was a higher prevalence of males among the patients with PVC cardiomyopathy compared to patients with normal LV function (51/76 [67%] vs 64/165 [39%]; P <.0001). The mean PVC burden was significantly higher in patients with PVC cardiomyopathy than in patients with normal LV function (28% ± 12% vs 15% ± 13%; P <.0001). Among symptomatic patients, those with cardiomyopathy had a significantly longer duration of palpitations (135 ± 118 months) compared with patients with normal LV function (35 ± 52 months; P <.0001). The proportion of asymptomatic patients was significantly higher in the presence of cardiomyopathy (36/76, 47%) than in normal LV function (25/165, 15%; P <.0001). Symptom duration of 30 to 60 months, symptom duration >60 months, the absence of symptoms, and the PVC burden in asymptomatic patients were independent predictors of impaired LV function (adjusted odds ratio [95% confidence interval]: 4.0 [1.1-14.4], 20.1 [6.3-64.1], 13.1 [4.1-37.8], and 2.1 [1.2-3.6], respectively). The duration of palpitations and the absence of symptoms are independently associated with PVC-induced cardiomyopathy. Copyright © 2012 Heart Rhythm Society. All rights reserved.

Citation

Miki Yokokawa, Hyungjin Myra Kim, Eric Good, Aman Chugh, Frank Pelosi, Craig Alguire, William Armstrong, Thomas Crawford, Krit Jongnarangsin, Hakan Oral, Fred Morady, Frank Bogun. Relation of symptoms and symptom duration to premature ventricular complex-induced cardiomyopathy. Heart rhythm : the official journal of the Heart Rhythm Society. 2012 Jan;9(1):92-5

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PMID: 21855522

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