EFFECTIVENESS OF MEDICAL TREATMENT FOR IDIOPATHIC FREQUENT PREMATURE VENTRICULAR COMPLEXES

Year 2025, Volume: 6 Issue: 3, 208 - 211, 25.11.2025

Kerem Can Yilmaz

Abstract

Introduction: Premature ventricular complexes (PVCs) are common arrhythmias in the clinical practice with an estimated prevalence of 1 to 4% in the general population. Also catheter ablation is recommended for first line treatment in symptomatic idiopathic ventricular tachycardia but medical treatment is reasanable. The aim of this study is to demonstrate the success rate of combined medical therapy and the factors influencing it in patients presenting with frequent idiopathic premature ventricular complexes.

Method: We retrospectively analyzed 60 adult patients who visited the cardiology outpatient clinic between 2022 and 2025. We diagnosed idiopathic PVC via electrocardiography at hospital admission and underwent ambulatory 24-hour rhythm Holter monitoring. Patients were initially divided into two groups based on their response to drug therapy. The demographic data, PVC burden and counts on Holter monitoring, treatment duration, administered medications, and ECG characteristics of PVCs were compared between patients who responded to drug therapy and those who did not.

Results: There were two groups; Group 1 was drug-unresponsive group (n=32), Group 2 (n=28) was drug-responsive group. After first treatment period we chanaged and proceed additional medical therapy in drug-unresponsive group. There was significantly positive response to treatment in patients with a transition at V4 in PVCs. We showed that PVC count and burden was significantly higher then in the drug-responsive group, 3 of 32 patients had ablation after first treatment. In the second treatment group (n=29), more than an 80% reduction in PVC burden was observed in 14 of the 29 patients. Overall, 42 out of 60 patients (70%) showed a response to medical therapy.

Conclusion: As a result, combination therapy may be given to patients who are not considering interventional treatment for first option or who has not possibility to reach early for ablation.

Keywords

arrhythmia , premature ventricular complex , ablation

İDYOPATİK SIK PREMATÜRE VENTRİKÜLER KOMPLEKSLERİN MEDİKAL TEDAVİSİNİN ETKİNLİĞİ

Abstract

Giriş: Prematür ventriküler kompleksler (PVC'ler), genel popülasyonda yaklaşık %1 ila %4 arasında görülen yaygın aritmilerdir. Semptomatik idiyopatik ventriküler taşikardi hastalarında birinci basamak tedavi olarak kateter ablasyonu önerilmektedir, ancak medikal tedavi de makul bir seçenektir. Bu çalışmanın amacı, sık idiyopatik prematür ventriküler komplekslerle başvuran hastalarda kombine medikal tedavinin başarı oranını ve başarıyı etkileyen faktörleri göstermekdir.

Yöntem: 2022 ile 2025 yılları arasında kardiyoloji polikliniğine başvuran 60 yetişkin hasta retrospektif olarak analiz edildi. İdiyopatik PVC tanısı, hastane kabulündeki elektrokardiyografi (EKG) ile konuldu ve hastalara 24 saatlik ritim holter monitörizasyonu yapıldı. Hastalar, ilaç tedavisine yanıtlarına göre başlangıçta iki gruba ayrıldı. Demografik veriler, Holter monitörizasyonundaki PVC yükü ve sayıları, tedavi süresi, uygulanan ilaçlar ve PVC’lerin EKG özellikleri, ilaç tedavisine yanıt veren ve vermeyen hastalar arasında karşılaştırıldı.

Bulgular: Çalışmadaki ilk iki grup; Grup 1, ilaçlara yanıt vermeyen grup (n=32), Grup 2 ise ilaçlara yanıt veren grup (n=28) olarak belirlendi. İlk tedavi döneminden sonra, ilaçlara yanıt vermeyen grupta tedavi değiştirildi ve ek medikal tedaviye devam edildi. PVC'lerde V4 geçişi olan hastalar, PVC sayısı ve yükü fazla olan hastalar ilaçlara yanıt veren grupta anlamlı olarak daha yüksek saptandı. İlk tedavi sonrası 32 hastanın 3’üne ablasyon uygulandı. İkinci tedavi grubundaki 29 hastanın 14’ünde PVC yükünde %80’den fazla azalma görüldü. Toplamda 60 hastanın 42’sinde (%70) medikal tedaviye yanıt olduğu görüldü.

Sonuç: Sonuç olarak, girişimsel tedaviyi ilk seçenek olarak düşünmeyen veya ablasyona erken ulaşma imkânı olmayan hastalarda kombine ilaç tedavisi ilk seçenek olarak uygulanabilir.

Keywords

aritmi , prematür ventriküler kompleks , ablasyon

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