Premature ventricular contraction-induced cardiomyopathy: Related clinical and electrophysiologic parameters

Abstract

Background: Factors associated with premature ventricular contraction-induced cardiomyopathy (PVCi-CMP) remain debated.

Objective: The purpose of this study was to test the correlation of various factors to the presence PVCi-CMP in a large multicenter population.

Methods: One hundred sixty-eight consecutive patients referred for ablation of frequent premature ventricular contractions (PVCs) were included. Patients were divided into 2 groups: group 1 with suspected PVCi-CMP (96 patients, ejection fraction 38% ± 10%, left ventricular end-diastolic diameter 62 ± 8 mm, with or without additional structural heart disease); and group 2 (control group, 72 patients with normal ejection fraction and left ventricular dimensions). Various clinical and electrophysiologic parameters were compared between groups.

Results: In univariate analysis, left ventricular origin of PVC, lack of palpitations, long PVC coupling interval, epicardial origin of the focus, long sinus beat QRS duration, male gender, high PVC burden, presence of polymorphic PVCs, high PVC QRS duration, and older age were significantly related to the presence of PVCi-CMP. In multivariate analysis, only lack of palpitations, PVC burden, and epicardial origin remained significantly and independently correlated with the presence of cardiomyopathy. Even if sinus QRS duration or PVC left ventricular origin were also found independently linked to PVCi-CMP in the whole population, they were no longer correlated when patients with additional heart disease were excluded.

Conclusion: Lack of palpitations, PVC burden, and epicardial origin are independent factors that identify patients prone to developing PVCi-CMP.

Keywords: Cardiomyopathy; Premature ventricular contraction; Radiofrequency ablation; Tachycardia-induced cardiomyopathy.