PVCs – ARE THEY MORE SERIOUS THAN YOU THINK

PVCs – ARE THEY MORE SERIOUS THAN YOU THINK

PVCs – ARE THEY MORE
SERIOUS THAN YOU THINK
Krishna Kishore Gaddam, MD
Heart South Cardiovascular Group
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J Am Coll Cardiol. 2013;62(16):e147-239
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Scatter plots showing the relationship between the left
ventricular end-diastolic internal dimension and frequency
of premature ventricular complex (%PVC) (n = 40)
Takemoto M et al. J Am Coll Cardiol 2005;45:1259-65
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Putative mechanisms of PVC induced
cardiomyopathy
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2012;5:229-236
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24-h Holter Monitoring Analysis in Patients With Successful Procedure
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Treatment Group
Control Group
Bogun F et al. Heart Rhythm 2007;4:863-7
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Diagnosis, treatment and follow-up of patients presenting
frequent premature ventricular contractions (PVCs)
Yong-Mei Cha et al. Circ Arrhythm Electrophysiol. 2012;5:229-236
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PVC/VT Ablation – Procedure and
Risks
 Access – 8Fr Rt. Common Femoral vein access +/8Fr Rt. Common Femoral arterial access, rarely
epicardial
 3D Mapping/Fluoroscopy/+/- Intracardiac
echocardiography
 Risks – Bleeding, hematoma/fistula, pericardial
effusion/tamponade, open heart surgery, stroke,
acute MI, respiratory failure, death
 Usually discharged same day. May require
overnight stay if left sided ablation performed
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Premature ventricular contractions (PVCs) are an
under recognized cause of cardiomyopathy
Evaluation – Echo, 24hr Holter, +/- MRI, stress test
and LHC
Medical therapy not ususally very effective
Radiofrequency ablation of PVCs particularly with
a burden > 10% may improve LV size (which often
is a precursor of LV dysfunction) and LV function
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