title: Relation of symptoms and symptom duration to premature ventricular complex-induced cardiomyopathy.
abstract: BACKGROUND
  Frequent idiopathic premature ventricular complexes (PVCs) can result in a reversible form of cardiomyopathy. In this study, the determinants of PVC-induced left ventricular (LV) dysfunction were assessed.
  
  
  METHODS
  The subjects of this study were 241 consecutive patients (115 men [48%], mean age 48 ± 14 years) referred for ablation of frequent PVCs. One hundred eighty patients (75%) experienced palpitations and 61 (25%) did not. The PVC burden was determined by 24-hour Holter monitoring, and echocardiograms were performed to assess LV function. An LV ejection fraction of <50% was considered abnormal.
  
  
  RESULTS
  LV ejection fraction (mean 0.36 ± 0.09) was present in 76 of 241 patients (32%). There was a higher prevalence of males among the patients with PVC cardiomyopathy compared to patients with normal LV function (51/76 [67%] vs 64/165 [39%]; P <.0001). The mean PVC burden was significantly higher in patients with PVC cardiomyopathy than in patients with normal LV function (28% ± 12% vs 15% ± 13%; P <.0001). Among symptomatic patients, those with cardiomyopathy had a significantly longer duration of palpitations (135 ± 118 months) compared with patients with normal LV function (35 ± 52 months; P <.0001). The proportion of asymptomatic patients was significantly higher in the presence of cardiomyopathy (36/76, 47%) than in normal LV function (25/165, 15%; P <.0001). Symptom duration of 30 to 60 months, symptom duration >60 months, the absence of symptoms, and the PVC burden in asymptomatic patients were independent predictors of impaired LV function (adjusted odds ratio [95% confidence interval]: 4.0 [1.1-14.4], 20.1 [6.3-64.1], 13.1 [4.1-37.8], and 2.1 [1.2-3.6], respectively).
  
  
  CONCLUSIONS
  The duration of palpitations and the absence of symptoms are independently associated with PVC-induced cardiomyopathy.
authors.affiliation: Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, Michigan, USA.
authors.forename: Miki
authors.initials: M
authors.lastname: Yokokawa
authors.forename: Hyungjin Myra
authors.initials: HM
authors.lastname: Kim
authors.forename: Eric
authors.initials: E
authors.lastname: Good
authors.forename: Aman
authors.initials: A
authors.lastname: Chugh
authors.forename: Frank
authors.initials: F
authors.lastname: Pelosi
authors.forename: Craig
authors.initials: C
authors.lastname: Alguire
authors.forename: William
authors.initials: W
authors.lastname: Armstrong
authors.forename: Thomas
authors.initials: T
authors.lastname: Crawford
authors.forename: Krit
authors.initials: K
authors.lastname: Jongnarangsin
authors.forename: Hakan
authors.initials: H
authors.lastname: Oral
authors.forename: Fred
authors.initials: F
authors.lastname: Morady
authors.forename: Frank
authors.initials: F
authors.lastname: Bogun
mesh_terms: D009202:Cardiomyopathies / Q000209:etiology*; D017115:Catheter Ablation / Q000379:methods*; D004452:Echocardiography; D015716:Electrocardiography, Ambulatory; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013318:Stroke Volume; D018487:Ventricular Dysfunction, Left / Q000209:etiology*; D018879:Ventricular Premature Complexes / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology