Chronic frequent premature ventricular complexes originating from right and non-right ventricular outfow tracts: Change in left ventricular function after radiofrequency catheter ablation

Frequent premature ventricular complexes (PVCs) from the right ventricular outfow tract (RVOT) have recently been reported to be a cause of dilated cardiomyopathy. We studied the clinical impact of the elimination of PVCs from RVOT and non-RVOT. Thirty-six patients with symptomatic PVCs that were treated with radiofrequency catheter ablation (RFCA) were studied. The patients were assigned to one of two groups according to the origin of the PVCs (group I, RVOT-origin, n = 24; group II, non-RVOT-origin, n = 12) and observed for 10.5 ± 7.1 months. The burden of PVCs at baseline was 19.7 ± 10.6% and 18.7 ± 8.7% in group I and group II, respectively (P = 0.779). In group II, hypertension was more common (16.7% versus 58.3%, P = 0.020) and LV diastolic function was worse (Em, 8.7 ± 3.0 versus 6.4 ± 1.8 cm/second, P = 0.018). The LV end diastolic volume index (LVEDVI) decreased in both groups (59.7 ± 14.6 to 50.9 ± 9.6 mL/m², P = 0.004 in group I; 60.0 ± 19.9 to 51.6 ± 12.4 mL/m², P = 0.044 in group II), while the left atrial volume index (LAVI) decreased only in group I (36.7 ± 11.7 to 31.7 ± 10.0 mL/m², P = 0.002 in group I; 35.6 ± 11.9 to 33.8 ± 10.3 mL/m², P = 0.317 in group II). The left ventricular ejection fraction (LVEF) significantly improved in both groups (51.1 ± 6.6 to 59.8 ± 7.2%, P < 0.01 in group I; 49.9 ± 6.9 to 59.0 ± 5.9%, P < 0.01 in group II). RFCA of PVCs leads to a reduction of LV volume and improvement of LV systolic function regardless of the origin of the PVCs. Conversely, a non-RVOT-origin as well as an RVOT-origin of the PVCs can cause DCM-like changes in the left ventricle.