Patients’ characteristics and procedural outcomes of premature ventricular complex ablation: Data of a single-centre arrhythmia unit experience

Year 2024, , 1 - 4, 28.01.2024

Serdar Demır , Ayhan Kup , Kamil Gulsen , Abdulkadir Uslu Ayhan Tosun Mehmet Çelik , Cagan Yıldırım , Taylan Akgun , Alper Kepez

https://doi.org/10.5472/marumj.1378571

Abstract

Objective: Premature ventricular complexes (PVCs) are common arrhythmias and catheter ablation (CA) is the major treatment in
patients with PVCs. In this study, we aimed to share our experience on PVCs patients who had undergone CA.
Patients and Methods: We investigated consecutive patients who had undergone CA because of PVCs between January 2015 and
March 2021 in a single centre arrhythmia unit. Patients’ characteristics, rhythm Holter recordings, echocardiography results and CA
outcomes were noted. Patients were followed up for 22.3±3.7 months. Descriptive statistics were used to demonstrate features of study
patients.
Results: Study population consisted of 645 patients; mean age was 51 ± 4.14 and 372 (57.7%) were male. Arrhythmia originated
from the right ventricular outflow tract in 279 (46.6 %) patients, coronary cusps in 161 (26.9 %) patients, left ventricle summit in 50
(8.3%) patients and inside of the right or left ventricle in remaining patients. Sustained procedural success was achieved in 526 (88.1
%) patients. Recurrence was observed in 46 (6.7%) patients during follow-up. Major complication occurred in two patients (one
procedural mortality due to coronary artery injury and one tamponade).
Conclusion: Premature ventricular contraction ablation can be utilized safely with high success rate. Most PVCs originate from the
right or left ventricular outflow tract.

Keywords

Premature ventricular complexes, Catheter ablation, Outflow tract, Mapping

References

• Ng GA. Treating patients with ventricular ectopic beats. Heart 2006;92: 1707–12. doi: 10.1136/hrt.2005.067843
• Kennedy HL, Whitlock JA, Sprague MK, et al. Long-term follow-up of asymptomatic healthy subjects with frequent and complex ventricular ectopy. N Engl J Med 1985;312:193-7. 1985;312:193-7. doi: 10.1056/NEJM198.501.243120401.
• Lee AK, Deyell MW. Premature ventricular contractioninduced cardiomyopathy. Curr Opin Cardiol 2016 ;31:1-10. doi: 10.1097/HCO.000.000.0000000236
• Kobayashi Y. Idiopathic ventricular premature contraction and ventricular tachycardia: distribution of the origin, diagnostic algorithm, and catheter ablation. J Nippon Med Sch 2018;85:87-94. doi: 10.1272/jnms.2018_85-14.
• Zhong L, Lee YH, Huang XM, et al. Relative efficacy of catheter ablation vs antiarrhythmic drugs in treating premature ventricular contractions: a single-center retrospective study. Heart Rhythm 2014;11:187-93. doi: 10.1016/j. hrthm.2013.10.033
• Lang RM, Badano LP, Mor‐Avi V, et al. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging 2015;16:233-70. doi: 10.1016/j. echo.2014.10.003
• Drew BJ, Califf RM, Funk M, Kaufman ES, et al. American Heart Association. AHA scientific statement: practice standards for electrocardiographic monitoring in hospital settings: an American Heart Association Scientific Statement from the Councils on Cardiovascular Nursing, Clinical Cardiology, and Cardiovascular Disease in the Young: endorsed by the International Society of Computerized electrocardiology and the American Association of Critical- Care Nurses. J Cardiovasc Nurs 2005;20:76-106. doi: 10.1097/00005.082.200503000-00003
• Hingorani P, Karnad DR, Rohekar P, et al. Arrhythmias seen in baseline 24-hour holter ecg recordings in healthy normal volunteers during phase 1 clinical trials. J Clin Pharmacol 2016;56:885-93. doi: 10.1002/jcph.679
• Tran CT, Calkins H. Premature ventricular contraction-induced cardiomyopathy: an emerging entity. Expert Rev Cardiovasc Ther 2016 ;14:1227-34. doi: 10.1080/14779.072.2016.1222901.
• Ling Z, Liu Z, Su L, et al. Radiofrequency ablation versus antiarrhythmic medication for treatment of ventricular premature beats from the right ventricular outflow tract: prospective randomized study. Circ Arrhythm Electrophysiol 2014;7: 237-43. doi: 10.1161/CIRCEP.113.000805
• Beiert T, Knappe V, Tiyerili V, et al. Chronic lower-dose relaxin administration protects from arrhythmia in experimental myocardial infarction due to anti-inflammatory and antifibrotic properties. Int J Cardiol 2018 ;250:21-8. doi: 10.1016/j. ijcard.2017.09.017.
• Komatsu Y, Hocini M, Nogami A, et al. Catheter ablation of refractory ventricular fibrillation storm after myocardial infarction. Circulation 2019;139:2315-25. doi: 10.1161/ CIRCULATIONAHA.118.037997.
• Marcus GM. Evaluation and management of premature ventricular complexes. Circulation 2020;141:1404-18. doi: 10.1161/CIRCULATIONAHA.119.042434
• Fedida J, Strisciuglio T, Sohal M, et al. Efficacy of advanced pace-mapping technology for idiopathic premature ventricular complexes ablation. J Interv Card Electrophysiol 2018 ;51:271- 7. doi: 10.1007/s10840.018.0320-8.
• Lamba JL, Redfearn DP, Michael KA, et al. Radiofrequency catheter ablation for the treatment of idiopathic premature ventricular contractions originating from the right ventricular outflow tract: a systematic review and metaanalysis. Pacing Clin Electrophysiol 2014;37:73-8. doi: 10.1111/pace.12243
• Zang M, Zhang T, Mao J, et al. Beneficial effects of catheter ablation of frequent premature ventricular complexes on left ventricular function. Heart 2014;100:787-93. doi: 10.1136/ heartjnl-2013-305175