Frequent premature ventricular complexes originating from the right ventricular outflow tract are associated with left ventricular dysfunction

Ann Noninvasive Electrocardiol. 2008 Jan;13(1):81-5. doi: 10.1111/j.1542-474X.2007.00204.x.

Abstract

Background: 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.

Methods: 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.

Results: 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).

Conclusion: We demonstrated a significant association between frequent RVOT PVCs and LV dysfunction in patients without structural heart disease.

MeSH terms

  • Bundle-Branch Block / epidemiology
  • Comorbidity
  • Electrocardiography, Ambulatory / methods
  • Electrocardiography, Ambulatory / statistics & numerical data
  • Female
  • Heart Ventricles / physiopathology*
  • Humans
  • Male
  • Middle Aged
  • Odds Ratio
  • Predictive Value of Tests
  • Prevalence
  • Retrospective Studies
  • Tachycardia, Ventricular / epidemiology
  • Time Factors
  • Ventricular Dysfunction, Left / epidemiology*
  • Ventricular Premature Complexes / epidemiology*