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Premature ventricular contraction induced cardiomyopathy

Gabriela M Orgeron, Cynthia A James, Anneline Te Riele, Crystal Tichnell, Brittney Murray, Aditya Bhonsale, Ihab R Kamel, Stephan L Zimmerman, Daniel P Judge, Jane Crosson, Harikrishna Tandri, Hugh Calkins
BACKGROUND: Arrhythmogenic right ventricular dysplasia/cardiomyopathy is characterized by ventricular arrhythmias and sudden cardiac death. Once the diagnosis is established, risk stratification to determine whether implantable cardioverter-defibrillator (ICD) placement is warranted is critical. METHODS AND RESULTS: The cohort included 312 patients (163 men, age at presentation 33.6±13.9 years) with definite arrhythmogenic right ventricular dysplasia/cardiomyopathy who received an ICD...
June 6, 2017: Journal of the American Heart Association
Esseim Sharma, Karuppiah Arunachalam, Mengyang Di, Antony Chu, Abhishek Maan
Premature ventricular contractions (PVCs) are common arrhythmias noticed in the clinical setting because of premature depolarization of the ventricular myocytes. Although often thought to be reflective of underlying disease rather than intrinsically harmful, PVCs have recently been linked with worse outcomes in patients without significant cardiac disease. Long-term exposure to a high PVC burden can lead to the development of PVC-induced cardiomyopathy. The pathogenesis of this condition is poorly understood at the current time...
June 2017: Critical Pathways in Cardiology
Kyoung-Min Park, Sung Il Im, Seung-Jung Park, June Soo Kim, Young Keun On
No abstract text is available yet for this article.
April 28, 2017: International Journal of Cardiology
Kyoung-Min Park, Sung Il Im, Seung-Jung Park, June Soo Kim, Young Keun On
BACKGROUND: Premature ventricular contraction (PVC) QRS duration (QRSd) and high PVCs burden are known as a risk factor of PVC-induced cardiomyopathy (CMP). The aim of this study is to find useful algorithm to predict PVC-induced CMP. METHODS: 180 patients (99 males, 51±14years) with frequent PVCs (>10%/24h), who underwent successful PVC ablation, were studied. Typical PVC-related symptoms were defined as the presence of palpitations or dropped beats during PVC...
April 15, 2017: International Journal of Cardiology
Wael A Alqarawi, F Daniel Ramirez, Pablo B Nery, Calum J Redpath, Mouhannad M Sadek, Martin S Green, David H Birnie, Girish M Nair
Premature ventricular contraction (PVC)-induced cardiomyopathy is increasingly being recognized as a reversible cause of left ventricular (LV) systolic dysfunction (LVSD). The diagnosis of PVC-induced cardiomyopathy is considered in subjects with high PVC burdens (> 10,000 per 24 hours) after excluding other known causes of LVSD. PVC suppression is the mainstay of the management of PVC-induced cardiomyopathy, in addition to proven evidence-based medical therapy recommended for subjects with LVSD. Management strategies for PVC-induced cardiomyopathy include medical therapy and/or catheter ablation, with an increasing role for catheter ablation as a first-line therapy in view of the potential for permanent suppression of PVCs...
February 2017: Canadian Journal of Cardiology
Cao Thach Tran, Hugh Calkins
Over the past 10-15 years, there has been an increasing amount of evidence that frequent premature ventricular contractions (PVCs) are associated with the development of a reversible cardiomyopathy. Areas covered: This review considers current evidence of the association between PVCs and the development of cardiomyopathy, risk factors, and available treatment modalities based on available published literature. Expert commentary: The field is rapidly evolving, although evidence is based primarily on observational studies...
November 2016: Expert Review of Cardiovascular Therapy
Marie Sadron Blaye-Felice, David Hamon, Frederic Sacher, Patrizio Pasquale, Anne Rollin, Vanina Bongard, Alexandre Duparc, Pierre Mondoly, Nicolas Derval, Arnaud Denis, Christelle Cardin, Mélèze Hocini, Pierre Jaïs, Etienne Pruvot, Jurg Schlaepfer, Didier Carrié, Michel Galinier, Nicolas Lellouche, Michel Haïssaguerre, Philippe Maury
BACKGROUND: Suppression of frequent premature ventricular contractions (PVCs) does not systematically lead to an expected reversal of PVC-induced cardiomyopathy and determinants of left ventricular ejection fraction (LVEF) recovery (reverse remodeling) after ablation remain largely unknown. METHODS: Ninety-six consecutive patients with a suspicion of PVC induced-cardiomyopathy were retrospectively included. Parameters potentially related to reverse remodeling (>10% increase in LVEF) were analyzed in patients w/wo long-term success (decrease in PVC burden >80%)...
November 1, 2016: International Journal of Cardiology
A Chantepie, N Soulé, J Poinsot, F Labarthe, B Lefort
We report on the rare case of 7-year-old child presenting with frequent and apparently benign premature ventricular complexes (VPC) and left ventricular dysfunction. No structural disease of the heart was seen at cardiological evaluation. Eighteen months after the introduction of an antiarrhythmic treatment with low-dose bisoprolol, Holter monitoring showed 70,000 VPC in 24h with left ventricular function remaining decreased. Six months after increasing the dose of bisoprolol, the VPC were less frequent and left ventricular function was completely normalized...
July 2016: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
Noriko Motoki, Yuji Inaba, Satoshi Matsuzaki, Yohei Akazawa, Takafumi Nishimura, Tetsuhiro Fukuyama, Kenichi Koike
BACKGROUND: Tuberous sclerosis complex (TSC) is an autosomal-dominant tumor suppressor gene syndrome that is characterized by the development of distinctive benign tumors and malformations in multiple organ systems (N Eng J Med 355:1345-1356, 2006). Cardiac rhabdomyomas are intracavitary or intramural tumors observed in 50-70 % of infants with TSC but only cause serious clinical problems in a very small fraction of these patients (N Eng J Med 355:1345-1356, 2006; Pediatrics 118:1146-1151, 2006; Eur J Pediatr 153:155-7, 1994); most individuals have no clinical symptoms and their tumors spontaneously regress...
January 25, 2016: BMC Pediatrics
Stefano Pedretti, Sara Vargiu, Marco Paolucci, Maurizio Lunati
A 77-year-old man with ischemic cardiomyopathy and a cardiac resynchronization therapy-defibrillator (CRT-D) device came to our attention due to incessant ventricular tachycardia and multiple implantable cardioverter defibrillator (ICD) shocks. An electrocardiogram showed non-sustained monomorphic ventricular tachycardias (NSVTs) constantly occurring after each biventricular stimulation. During an electrophysiological study, NSVTs reproducibly recurred only after right ventricular (RV) pacing; LV pacing did not induce any NSVTs...
December 2015: Journal of Arrhythmia
Andrea K Y Lee, Marc W Deyell
PURPOSE OF REVIEW: There has been a resurgent interest in frequent premature ventricular contractions (PVCs) led by the novel concept that they may be a potential cause of, or at least contribute to, cardiomyopathy. This review evaluates recent advances in our understanding of PVC-induced cardiomyopathy. RECENT FINDINGS: Recent studies have focused on identifying the predictors of PVC-induced cardiomyopathy, with the most consistent predictors being PVC burden and PVC QRS duration...
January 2016: Current Opinion in Cardiology
Alex Y Tan, Yuhning L Hu, Jonathan Potfay, Karoly Kaszala, Maureen Howren, Adam P Sima, Michael Shultz, Jayanthi N Koneru, Kenneth A Ellenbogen, Jose F Huizar
BACKGROUND: Frequent premature ventricular contractions (PVCs) have been associated with PVC-induced cardiomyopathy (CM) in some patients. OBJECTIVE: The purpose of this study was to understand the cardiac consequences of different PVC burdens and the minimum burden required to induce left ventricular (LV) dysfunction. METHODS: Right ventricular apical PVCs at a coupling interval of 240 ms were introduced at different PVC burdens in 9 mongrel canines...
March 2016: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Min Jiang, Mei Zhang, Maureen Howren, Yuhong Wang, Alex Tan, Ravi C Balijepalli, Jose F Huizar, Gea-Ny Tseng
BACKGROUND: In a canine model of premature ventricular contraction-induced cardiomyopathy (PVC-CM), Cav1.2 is downregulated and misplaced from transverse tubules (T tubules). Junctophilin-2 (JPH-2) is also downregulated. OBJECTIVES: The objectives of this study were to understand the role of JPH-2 in PVC-CM and to probe changes in other proteins involved in dyad structure and function. METHODS: We quantify T-tubule contents (di-8-ANEPPS fluorescence in live myocytes), examine myocyte ultrastructures (electron microscopy), probe JPH-2-interacting proteins (co-immunoprecipitation), quantify dyad and nondyad protein levels (immunoblotting), and examine subcellular distributions of dyad proteins (immunofluorescence/confocal microscopy)...
March 2016: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Yasuaki Tanaka, Dolkun Rahmutula, Srikant Duggirala, Babak Nazer, Qizhi Fang, Jeffrey Olgin, Richard Sievers, Edward P Gerstenfeld
BACKGROUND: Frequent premature ventricular contractions (PVCs) may lead to dilated cardiomyopathy. A leftward shift in the unipolar voltage distribution in patients with cardiomyopathy has also been described and attributed to increased fibrosis. OBJECTIVES: We established a swine model of PVC-induced cardiomyopathy and assessed (1) whether an increase in left ventricular fibrosis occurs and (2) whether increased fibrosis leads to a leftward shift in the unipolar voltage distribution...
February 2016: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Carine F B van Huls van Taxis, Sebastiaan R D Piers, Marta de Riva Silva, Olaf M Dekkers, Daniël A Pijnappels, Martin J Schalij, Adrianus P Wijnmaalen, Katja Zeppenfeld
BACKGROUND: High idiopathic premature ventricular contractions (PVC) burden has been associated with PVC-induced cardiomyopathy. Patients may be symptomatic before left ventricular (LV) dysfunction develops. N-terminal pro-B-type natriuretic peptide (NT-proBNP) and circumferential end-systolic wall stress (cESS) on echocardiography are markers for increased ventricular wall stress. This study aimed to evaluate the relation between presenting symptoms, PVC burden, and increased ventricular wall stress in patients with frequent PVCs and preserved LV function...
December 2015: Circulation. Arrhythmia and Electrophysiology
Jonathan Potfay, Karoly Kaszala, Alex Y Tan, Adam P Sima, John Gorcsan, Kenneth A Ellenbogen, Jose F Huizar
BACKGROUND: Left ventricular (LV) dyssynchrony caused by premature ventricular contractions (PVCs) has been proposed as a mechanism of PVC-induced cardiomyopathy. We sought to understand the impact of different PVC locations and coupling intervals (prematurity) on LV regional mechanics and global function of the PVC beat itself. METHODS AND RESULTS: Using our premature pacing algorithm, pentageminal PVCs at coupling intervals of 200 to 375 ms were delivered from the epicardial right ventricular apex, RV outflow tract, and LV free wall, as well as premature atrial contractions, from the left atrial appendage at a coupling interval of 200 ms in 7 healthy canines...
October 2015: Circulation. Arrhythmia and Electrophysiology
Marie Sadron Blaye-Felice, David Hamon, Frédéric Sacher, Patrizio Pascale, Anne Rollin, Alexandre Duparc, Pierre Mondoly, Nicolas Derval, Arnaud Denis, Christelle Cardin, Mélèze Hocini, Pierre Jaïs, Jürg Schlaepfer, Vanina Bongard, Didier Carrié, Michel Galinier, Etienne Pruvot, Nicolas Lellouche, Michel Haïssaguerre, Philippe Maury
BACKGROUND: Factors associated with premature ventricular contraction-induced cardiomyopathy (PVCi-CMP) remain debated. OBJECTIVE: The purpose of this study was to test the correlation of various factors to the presence PVCi-CMP in a large multicenter population. METHODS: One hundred sixty-eight consecutive patients referred for ablation of frequent premature ventricular contractions (PVCs) were included. Patients were divided into 2 groups: group 1 with suspected PVCi-CMP (96 patients, ejection fraction 38% ± 10%, left ventricular end-diastolic diameter 62 ± 8 mm, with or without additional structural heart disease); and group 2 (control group, 72 patients with normal ejection fraction and left ventricular dimensions)...
January 2016: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Bruce B Lerman
Idiopathic ventricular arrhythmia is a generic term for a spectrum of arrhythmias that occur in the absence of structural heart disease or ion channelopathy. These arrhythmias include monomorphic premature ventricular contractions (PVCs), nonsustained monomorphic ventricular tachycardia (VT), and sustained VT. Most idiopathic ventricular arrhythmias originate from the right and left ventricular outflow tracts and include sites accessed from the aortic sinuses of Valsalva. Outflow tract arrhythmia is identified by an electrocardiographic pattern consistent with a left bundle branch block inferior axis morphology...
October 2015: Nature Reviews. Cardiology
Zebulon Z Spector, Stephen P Seslar
BACKGROUND: Adults with high premature ventricular contraction burden can develop left ventricular dilation, dysfunction, and strain, consistent with a cardiomyopathy, which is reversible with radiofrequency ablation of the premature ventricular contractions. Evidence in children with similar ectopy burden is limited. We performed a single-centre retrospective review to examine the prevalence of premature ventricular contraction-induced cardiomyopathy, natural history of ventricular ectopy, and progression to ventricular tachycardia in children with frequent premature ventricular contractions...
April 2016: Cardiology in the Young
Min-Soo Ahn
Premature ventricular contractions (PVCs) are early depolarizations of the myocardium originating in the ventricle. PVCs are common with an estimated prevalence of 40% to 75% in the general population on 24- to 48-hour Holter monitoring. Traditionally, they have been thought to be relatively benign in the absence of structural heart disease but they represent increased risk of sudden death in structural heart disease. Especially in ischemic heart disease, the frequency and complexity of PVCs is associated with mortality...
March 2013: Journal of Lifestyle Medicine
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