Document Detail


Radiofrequency catheter ablation of premature ventricular complexes from right ventricular outflow tract improves left ventricular dilation and clinical status in patients without structural heart disease.
MedLine Citation:
PMID:  15837259     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: The present study evaluated clinical benefits of radiofrequency catheter ablation (RFA) for premature ventricular complexes from right ventricular outflow tract (RVOT-PVC) in patients without structural heart disease. BACKGROUND: It is unknown whether PVC causes left ventricular (LV) dilation, which is a well-recognized precursor of LV dysfunction and heart failure, and whether eliminating PVC by RFA produces clinical benefits in patients with RVOT-PVC. METHODS: Frequency of PVC per total heart beats by 24-h Holter monitoring, left ventricular ejection fraction (LVEF), left ventricular end-diastolic internal dimension (LVDd), mitral regurgitation (MR) by echocardiogram, cardiothoracic ratio (CTR) by chest radiogram, and New York Heart Association (NYHA) functional class of 40 patients with RVOT-PVC without structural heart disease were evaluated before and 6 to 12 months after RFA. RESULTS: Before RFA, a subgroup of patients with frequent (>20%) PVC demonstrated significantly enlarged LVDd and CTR, reduced LVEF, increased MR, and deteriorated NYHA functional class as compared to the subgroup with rare (<20%) PVC (54 +/- 1 mm vs. 45 +/- 1 mm, 52 +/- 2% vs. 46 +/- 1%, 66 +/- 2% vs. 73 +/- 2%, 1.2 +/- 0.2 degree vs. 0.4 +/- 0.1 degree, and 1.8 +/- 0.2 vs. 1.3 +/- 0.1, respectively; p < 0.05). Furthermore, ablating RVOT-PVC readily produced the improvement of all these abnormalities (47 +/- 1 mm, 41 +/- 1%, 72 +/- 2%, 0.3 +/- 0.1 degree, and 1.0 +/- 0.0, respectively; p < 0.05 compared with before RFA). CONCLUSIONS: These findings suggest that frequent (>20%) RVOT-PVC may be a possible cause of LV dysfunction and/or heart failure, and RFA produces clinical benefits in these patients.
Authors:
Masao Takemoto; Hitoshi Yoshimura; Yurika Ohba; Yasuharu Matsumoto; Umpei Yamamoto; Masahiro Mohri; Hideo Yamamoto; Hideki Origuchi
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  45     ISSN:  0735-1097     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2005 Apr 
Date Detail:
Created Date:  2005-04-19     Completed Date:  2005-05-12     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1259-65     Citation Subset:  AIM; IM    
Affiliation:
Internal Medicine, Kyushu Kosei-Nenkin Hospital, Kitakyushu, Japan. matakemo@aol.com
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MeSH Terms
Descriptor/Qualifier:
Catheter Ablation*
Echocardiography
Electrocardiography, Ambulatory
Female
Heart Failure / etiology
Heart Ventricles
Humans
Male
Middle Aged
Natriuretic Peptide, Brain / blood
Radiography, Thoracic
Stroke Volume
Treatment Outcome
Ventricular Dysfunction, Left / etiology
Ventricular Premature Complexes / surgery*
Chemical
Reg. No./Substance:
114471-18-0/Natriuretic Peptide, Brain
Comments/Corrections
Comment In:
J Am Coll Cardiol. 2005 Apr 19;45(8):1266-8   [PMID:  15837260 ]

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


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