@article {Penela378, author = {Diego Penela and Mikel Mart{\'\i}nez and Juan Fern{\'a}ndez-Armenta and Luis Aguinaga and Luis Tercedor and Augusto Ord{\'o}{\~n}ez and Juan Acosta and Julio Mart{\'\i}-Almor and Felipe Bisbal and Luca Rossi and Roger Borr{\`a}s and Markus Linhart and David Soto-Iglesias and Beatriz J{\'a}uregui and Jos{\'e} T Ortiz-P{\'e}rez and Rosario J Perea and Xavier Bosch and Lluis Mont and Antonio Berruezo}, title = {Influence of myocardial scar on the response to frequent premature ventricular complex ablation}, volume = {105}, number = {5}, pages = {378--383}, year = {2019}, doi = {10.1136/heartjnl-2018-313452}, publisher = {BMJ Publishing Group Ltd}, abstract = {Objective This study aims to evaluate the influence of myocardial scar after premature ventricular complexes (PVC) ablation in patients with left ventricular (LV) dysfunction.Methods 70 consecutive patients (58{\textpm}11 years, 58 (83\%) men, 23\% (18{\textendash}32) mean PVC burden) with LV dysfunction and frequent PVCs submitted for ablation were included. A late gadolinium enhancement cardiac magnetic resonance (LGE-CMR) was performed prior to the ablation and a quantitative and qualitative analysis of the scar was done.Results Left ventricular ejection fraction progressively improved from 34.3\%{\textpm}9\% at baseline to 44.4\%{\textpm}12\% at 12 months (p\<0.01) and 48 (69\%) patients were echocardiographic responders. New York Heart Association class improved from 1.96{\textpm}0.9 points at baseline to 1.36{\textpm}0.6 at 12 months (p\<0.001). Brain natriuretic peptide decreased from 120 (60{\textendash}284) to 46 (23{\textendash}81) pg/mL (p=0.04). Twenty-nine (41\%) patients showed scar in the preprocedural LGE-CMR with a mean scar mass of 10.4 (5{\textendash}20) g. Mean scar mass was significantly smaller in responders than in non-responders (0 (0{\textendash}4.7) g vs 2 (0{\textendash}14) g, respectively, p=0.017). PVC burden reduction (OR 1.09 (1.01{\textendash}1.16), p=0.02) and scar mass (OR 0.9 (0.81{\textendash}0.99), p=0.04) were independent predictors of response, but the former showed a higher accuracy.Conclusions Presence of myocardial scar modulates, but does not preclude, the probability of response to PVC ablation in patients with LV dysfunction.}, issn = {1355-6037}, URL = {https://heart.bmj.com/content/105/5/378}, eprint = {https://heart.bmj.com/content/105/5/378.full.pdf}, journal = {Heart} }