title: Radiofrequency catheter ablation of premature ventricular complexes from right ventricular outflow tract improves left ventricular dilation and clinical status in patients without structural heart disease.
abstract: OBJECTIVE
  The present study evaluated clinical benefits of radiofrequency catheter ablation (RFA) for premature ventricular complexes from right ventricular outflow tract (RVOT-PVC) in patients without structural heart disease.
  
  
  BACKGROUND
  It is unknown whether PVC causes left ventricular (LV) dilation, which is a well-recognized precursor of LV dysfunction and heart failure, and whether eliminating PVC by RFA produces clinical benefits in patients with RVOT-PVC.
  
  
  METHODS
  Frequency of PVC per total heart beats by 24-h Holter monitoring, left ventricular ejection fraction (LVEF), left ventricular end-diastolic internal dimension (LVDd), mitral regurgitation (MR) by echocardiogram, cardiothoracic ratio (CTR) by chest radiogram, and New York Heart Association (NYHA) functional class of 40 patients with RVOT-PVC without structural heart disease were evaluated before and 6 to 12 months after RFA.
  
  
  RESULTS
  Before RFA, a subgroup of patients with frequent (>20%) PVC demonstrated significantly enlarged LVDd and CTR, reduced LVEF, increased MR, and deteriorated NYHA functional class as compared to the subgroup with rare (<20%) PVC (54 +/- 1 mm vs. 45 +/- 1 mm, 52 +/- 2% vs. 46 +/- 1%, 66 +/- 2% vs. 73 +/- 2%, 1.2 +/- 0.2 degree vs. 0.4 +/- 0.1 degree, and 1.8 +/- 0.2 vs. 1.3 +/- 0.1, respectively; p < 0.05). Furthermore, ablating RVOT-PVC readily produced the improvement of all these abnormalities (47 +/- 1 mm, 41 +/- 1%, 72 +/- 2%, 0.3 +/- 0.1 degree, and 1.0 +/- 0.0, respectively; p < 0.05 compared with before RFA).
  
  
  CONCLUSIONS
  These findings suggest that frequent (>20%) RVOT-PVC may be a possible cause of LV dysfunction and/or heart failure, and RFA produces clinical benefits in these patients.
authors.affiliation: Internal Medicine, Kyushu Kosei-Nenkin Hospital, Kitakyushu, Japan. matakemo@aol.com
authors.forename: Masao
authors.initials: M
authors.lastname: Takemoto
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Yoshimura
authors.forename: Yurika
authors.initials: Y
authors.lastname: Ohba
authors.forename: Yasuharu
authors.initials: Y
authors.lastname: Matsumoto
authors.forename: Umpei
authors.initials: U
authors.lastname: Yamamoto
authors.forename: Masahiro
authors.initials: M
authors.lastname: Mohri
authors.forename: Hideo
authors.initials: H
authors.lastname: Yamamoto
authors.forename: Hideki
authors.initials: H
authors.lastname: Origuchi
mesh_terms: D017115:Catheter Ablation; D004452:Echocardiography; D015716:Electrocardiography, Ambulatory; D005260:Female; D006333:Heart Failure / Q000209:etiology; D006352:Heart Ventricles; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D013902:Radiography, Thoracic; D013318:Stroke Volume; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000209:etiology; D018879:Ventricular Premature Complexes / Q000601:surgery*
chemical_list: D020097:Natriuretic Peptide, Brain