The safety of catheter ablation for premature ventricular contractions in patients without structural heart disease

Jin-Sheng Wang,Yang-Pei Peng,Saroj Thapa,Kang-Ting Ji,Yi-Gen Shen,Lian-Ming Liao,Yang-Jing Xue,Jia-Feng Lin,Ri-Peng Yin

doi:10.1186/s12872-018-0913-2

Abstract

BackgroundPatients with frequent premature ventricular contractions (PVCs) are often symptomatic. Catheter ablation was usually indicated to eliminate symptoms in patients with PVCs-induced cardiomyopathy. Currently, PVCs-ablation is also applied for patients with PVCs and no structural heart diseases (SHD); however, the safety and efficacy of ablation in these patients remains unclear.MethodsIn this retrospective study, data from patients who underwent ablation for PVCs from January 2010 to December 2016 at our hospital was retrieved. Predictors of complications and acute procedural success were evaluated.ResultsA total of 1231 patients (mean age 47.8 ± 16.8 years, 59% female) were included. The overall complication rate was 2.7%, and the most common complication was hydropericardium. Two ablation-related mortalities occurred. One patient died of coronary artery injury during the procedure and the other died from infectious endocarditis. Location (left ventricle and epicardium) was the main predictor of complications, with right ventricular outflow tract (RVOT) predicting fewer complications. The acute procedural success rate was 94.1% in all patients. The main predictor of acute procedural success was RVOT origin, while an epicardial origin was a predictor of procedural failure.ConclusionLocations of left ventricle and epicardium were predictors of procedural complications for patients with PVCs. Therefore, ablation is not recommended in these patients. For other origins of PVCs, particularly RVOT origin, ablation is a safety and effective treatment.

Highlights

Patients with frequent premature ventricular contractions (PVCs) are often symptomatic
PVCs may be a consequence of subclinical cardiomyopathy and it is impossible to prospectively determine whether the PVCs or cardiomyopathy is the primary issue in one given patient [9,10,11]
This study demonstrated that most patients with PVCs and no structural heart diseases (SHD) would not develop into cardiomyopathy even if untreated

Summary

Introduction

Patients with frequent premature ventricular contractions (PVCs) are often symptomatic. Catheter ablation was usually indicated to eliminate symptoms in patients with PVCs-induced cardiomyopathy. Premature ventricular contractions (PVCs) are relatively common and can be detected in 75% of healthy persons using 48-h Holter [1]. Due to insufficient patient sample, predictors of PVC ablation were not evaluated in these studies. That we conducted this study to evaluate predictor of PVC ablation. Several studies have demonstrated an association between frequent PVCs and potentially reversible cardiomyopathy [6,7,8,9,10]. A recent cohort study reported no adverse cardiac events and no decline in overall left ventricular ejection fraction

Methods

Results

Discussion

Conclusion