Reversal of dilated cardiomyopathy by the elimination of frequent left or right premature ventricular contractions.
BACKGROUND
RF ablation of frequent premature ventricular contractions (PVC) has recently been shown to improve left ventricular (LV) systolic function and dimensions in a few patients, however mainly when they originated from the right ventricular outflow tract.


METHODS
RF ablation was performed at various ventricular locations in six consecutive patients with frequent, isolated PVC associated with idiopathic dilated cardiomyopathy (DCM). Baseline clinical status, PVC counts, LV ejection fraction (EF) and end-diastolic diameter (EDD) were recorded at baseline and at 6 months of follow-up.


RESULTS
PVC ablation was performed in the right ventricle in four patients, the left ventricle in two patients. Before RF ablation, five patients were in New York Heart Association (NYHA) functional class I, and one patient was in class II. After RF ablation, the mean PVC count/24 h decreased from 17,717 +/- 7,100 to 268 +/- 366 (p = 0.006) while LVEF increased from 42 +/- 2.5% to 57 +/- 3% (p = 0.0001) and LVEDD decreased from 60.0 +/- 3.5 to 54.0 +/- 3.7 mm (p = 0.0009). The clinical status normalized with regression of palpitations and NYHA class.


CONCLUSIONS
Elimination of frequent isolated PVC in patients with DCM with RF can normalize the clinical status and LV systolic function and dimensions, regardless of the morphology or origin of the PVC.
Taieb
Jerome M
JM
Cardiology, Hospital Center of Aix en Provence, Avenue des Tamaris, Aix en Provence, 13616, France. taiebj@free.fr
Maury
Philippe
P
Shah
Dipen
D
Duparc
Alexandre
A
Galinier
Michel
M
Delay
Marc
M
Morice
Ronan
R
Alfares
Ali
A
Barnay
Claude
C
D002311:Cardiomyopathy, Dilated / Q000150:complications* / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D055502:Secondary Prevention; D016896:Treatment Outcome; D018879:Ventricular Premature Complexes / Q000209:etiology* / Q000517:prevention & control*