Abstract
Should premature ventricular complex (PVC) ablation be performed empirically for patients with a normal left ventricular (LV) function? Assuming that the patient has had an extensive discussion regarding the risks and benefits of ablation of PVCs, the opinion of this author is that empiric treatment of these PVCs is reasonable, with the caveat that initial treatment of frequent PVCs should include medical therapy.
Highlights
Since most premature ventricular complex (PVC) are benign, the literature for patients undergoing premature ventricular complexes (PVCs) ablation has focused on the outcomes of patients with (1) symptomatic PVCs, (2) prevention of PVC-triggered ventricular fibrillation (VF), and (3) ablation of PVCs causing a PVC-induced cardiomyopathy
Our success in treating symptomatic PVCs has allowed us to consider the possibility of empiric ablation for frequent asymptomatic PVCs
Should the PVCs be truly asymptomatic, medical therapy with a beta-blocker and/or class 1C agent such as propafenone or flecainide should be initiated; my rationale for this approach is that medical therapy for treating asymptomatic frequent PVCs is analogous to treating asymptomatic hyperlipidemia and hypertension for prevention of future myocardial infarctions, stroke, and renal failure
Summary
Since most PVCs are benign, the literature for patients undergoing PVC ablation has focused on the outcomes of patients with (1) symptomatic PVCs, (2) prevention of PVC-triggered ventricular fibrillation (VF), and (3) ablation of PVCs causing a PVC-induced cardiomyopathy.
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