Frequent Premature Ventricular Complexes Originating from the Right Ventricular Outflow Tract Are Associated with Left Ventricular Dysfunction

Abstract

Recent case series have shown reversal of left ventricular (LV) dysfunction after catheter ablation of frequent premature ventricular complexes (PVCs) originating from the right ventricular outflow tract (RVOT). We conducted a retrospective study to evaluate the prevalence of patients with frequent RVOT PVCs (> or =10 per hour) and LV dysfunction. RVOT PVC was defined as PVC with left bundle branch block morphology and inferior axis on a 12-lead ECG. We included patients with frequent RVOT PVCs on 24-hours Holter monitor who had a recent evaluation of LV function. Patients with structural heart disease, including obstructive coronary artery disease, were excluded. Patients were divided into three groups based on the number of PVCs (<1000/24 hour, 1000-10,000/24 hour, > or =10,000/24 hour), and the prevalence of LV dysfunction was evaluated in each group. Our analysis included 108 patients: 24 patients had <1000PVCs/24 hour, 55 patients had 1000-10,000PVCs/24 hour, and 29 patients had > or =10,000PVCs/24 hour. The prevalence of LV dysfunction was 4%, 12%, and 34%, respectively (P = 0.02). With logistic regression analysis, non-sustained ventricular tachycardia was an independent predictor of LV dysfunction with odds ratio of 3.6 (1.3-10.1). We demonstrated a significant association between frequent RVOT PVCs and LV dysfunction in patients without structural heart disease.