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Frequent premature ventricular complexes and normal ejection fraction: to treat or not to treat?
  1. Ivo Roca-Luque,
  2. Lluis Mont
  1. Cardiology, Hospital Clinic, Universitat de Barcelona, Barcelona, Spain
  1. Correspondence to Dr Lluis Mont, Cardiology, Hospital Clinic, Universitat de Barclelona, Barcelona 08036, Spain; lmont{at}clinic.cat

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The first publications about the relevance of premature ventricular complexes (PVCs) appeared in the late 1970s.1 In patients with frequent PVCs without structural heart disease, the prognosis was no worse than in the general population. Therefore, it has been generally accepted that prognosis is linked to the presence or absence of structural heart disease rather than with the presence of PVC itself. On the other hand, ablation may improve ventricular ejection fraction in patients with frequent PVCs and systolic dysfunction.2 Those initial descriptions of the so-called PVC-induced cardiomyopathy increased the interest in the prognosis of patients with frequent PVCs.

Cohort studies have shown a relation between PVC burden, deterioration of left ventricular ejection fraction (LVEF)3 4 and cardiovascular events.4 5 Patients with the highest PVC burden (first quartile) showed three times greater odds of 5-year decrease in LVEF and an increased risk of heart failure and death.4 Therefore, it seems that frequent PVCs may result in left ventricular deterioration even in the absence of structural heart disease. Ablation of PVCs may improve LVEF in patients with left ventricular dilation or systolic dysfunction, …

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