Document Detail


Beneficial effects of catheter ablation on left ventricular and right ventricular function in patients with frequent premature ventricular contractions and preserved ejection fraction.
MedLine Citation:
PMID:  20659945     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Improvement of left ventricular ejection fraction (LVEF) after radiofrequency catheter ablation (RFCA) of frequent premature ventricular contractions (PVCs) has been reported. However, most patients with frequent PVCs have a normal LVEF. In these patients subtle and early forms of PVC-induced left and right ventricular (RV) impairment may not be detected by standard echocardiographic techniques. OBJECTIVE: To assess the effect of frequent PVCs on ventricular function in patients with preserved LVEF. METHODS: 49 patients (30 male, 49+/-16 years) with recent-onset (median 1.2 years), frequent PVCs (burden 26+/-13%) and 25 healthy controls were studied. Thirty-four patients with PVCs underwent successful RFCA. Two-dimensional echocardiography was performed at baseline and follow-up. LV volumes and LVEF were calculated by Simpson's rule. Tricuspid annulus plane systolic excursion and fractional area change were calculated to assess RV function. Multidirectional LV strain (radial, circumferential, longitudinal) and RV free-wall longitudinal strain were calculated by two-dimensional speckle tracking imaging. At baseline LVEF, volumes and RV dimensions were normal in patients and controls. RESULTS: Speckle tracking imaging demonstrated reduced LV and RV strain in patients with PVC as compared with controls. At follow-up there were no changes in LVEF, LV volumes and RV dimensions and function in patients successfully treated by RFCA and untreated patients. However, radial, circumferential and longitudinal strain improved significantly in patients after RFCA but remained unchanged in untreated patients. CONCLUSIONS: Frequent PVCs can induce subtle cardiac dysfunction detected by speckle tracking imaging analysis in patients without apparent cardiomyopathy. RFCA can successfully eliminate PVCs and improve cardiac function.
Authors:
Adrianus P Wijnmaalen; Victoria Delgado; Martin J Schalij; Carine F B van Huls van Taxis; Eduard R Holman; Jeroen J Bax; Katja Zeppenfeld
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Publication Detail:
Type:  Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Heart (British Cardiac Society)     Volume:  96     ISSN:  1468-201X     ISO Abbreviation:  Heart     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-07-27     Completed Date:  2010-08-19     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9602087     Medline TA:  Heart     Country:  England    
Other Details:
Languages:  eng     Pagination:  1275-80     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Catheter Ablation / methods*
Female
Follow-Up Studies
Humans
Image Interpretation, Computer-Assisted / methods
Male
Middle Aged
Stroke Volume / physiology
Treatment Outcome
Ventricular Dysfunction, Left / etiology*,  ultrasonography
Ventricular Dysfunction, Right / etiology*,  ultrasonography
Ventricular Premature Complexes / complications,  physiopathology,  surgery*,  ultrasonography

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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