Abstract

BACKGROUND
Frequent ventricular premature depolarizations (VPDs) can cause reversible left ventricular (LV) dysfunction. However, not all patients normalize their LV function after VPD elimination.
OBJECTIVE
To evaluate predictors of recovery of LV function following the elimination of frequent VPDs.
METHODS
We identified patients with ≥10% VPDs/24 h and an LV ejection fraction of <50% who underwent successful ablation between 2007 and 2011. Subjects were classified as having reversible (≥10% increase to a final LV ejection fraction of ≥50%) or irreversible (≤10% increase or final LV ejection fraction <50%) LV dysfunction on the basis of echocardiographic follow-up. A reference group with ≥10% VPDs but normal LV function was identified.
RESULTS
One hundred fourteen patients with ≥10% VPDs were identified; 66 had preserved and 48 had impaired LV function. Over a median follow-up of 10.6 months, 24 of 48 were classified as reversible and 13 of 48 as irreversible and 11 of 44 were excluded. There was a gradient of VPD QRS duration between the control, reversible, and irreversible groups (mean VPD QRS 135, 158, and 173 ms, respectively; P < .001). This gradient persisted even for the same site of origin. In multivariate analysis, the only independent predictor of irreversible LV function was VPD QRS duration (odds ratio 5.07 [95% confidence interval 1.22-21.01] per 10-ms increase).
CONCLUSION
In patients with LV dysfunction and frequent VPDs, we identified VPD QRS duration as the only independent predictor for the recovery of LV function after ablation. This suggests that VPD QRS duration may be a marker for the severity of underlying substrate abnormality.

Links

Publisher Full Text

Authors

Deyell MW, Park KM, Han Y, Frankel DS, Dixit S, Cooper JM, Hutchinson MD, Lin D, Garcia F, Bala R, Riley MP, Gerstenfeld E, Callans DJ, Marchlinski FE

Institution

Electrophysiology Section, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA.

Source

Heart rhythm : the official journal of the Heart Rhythm Society 9:9 2012 Sep pg 1465-72

MeSH

Antihypertensive Agents
Catheter Ablation
Diuretics
Electrocardiography
Female
Humans
Male
Middle Aged
Multivariate Analysis
Postoperative Period
Prognosis
Risk Factors
Stroke Volume
Time Factors
Ventricular Dysfunction, Left
Ventricular Function, Left
Ventricular Premature Complexes

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22640894