Abstract

Introduction: Atrial fibrillation (AF) and premature ventricular contractions (PVC) are common arrhythmias encountered in clinical practice. Theoretically, retrograde atrial conduction can occur in the presence of PVC, causing atrial ectopy. However, the clinical significance of this association is not defined yet. Hypothesis: We investigated the prevalence of AF in patients with PVC and its impact on PVC ablation. Methods:: Consecutive patients undergoing PVC ablation at our institution between 2016 and 2019 were included in this analysis. Patients with structural heart disease, hyperthyroidism, malignancy, alcoholism and advanced renal or hepatic disease were excluded. For all patients, 12-lead ECG was used to diagnose AF and assess PVC morphology. During the index procedure, all PVC morphologies were targeted for ablation. Patients were followed up with remote monitoring as well as ICD interrogations and office visits every 6 months for 2 years. Detection of any PVC in the electrogram was considered as recurrence. Results: A total of 394 patients undergoing PVC ablation were included of which 96 (24%) had the documented evidence of AF. Baseline characteristics of the study population without (group 1, n=298) versus with AF (group 2, n=96) is provided in table 1. Clinical parameters were comparable between the groups except age, which was higher in group 2. PVCs with multiple (≥2) morphology were detected at the index procedure in 41 (13.7%) and 58 (60.4%) patients in group 1 and 2 respectively (p <0.001). At 2 years of follow-up, recurrence rate following PVC-ablation was significantly higher in group 2 compared to group 1 (17 (18%) vs 27 (9%), p=0.026). Conclusions: In this consecutive series, AF was documented in 1/4 th of the population undergoing PVC ablation and presence of AF was associated with lower procedural success at long term, which could be attributed to older age and significantly higher prevalence of multiple morphology’ PVCs in the group 2 population.

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