title: Relative efficacy of catheter ablation vs antiarrhythmic drugs in treating premature ventricular contractions: a single-center retrospective study.
abstract: BACKGROUND
  It is unknown whether radiofrequency ablation (RFA) or antiarrhythmic therapy is superior when treating patients with symptomatic premature ventricular contractions (PVCs).
  
  
  OBJECTIVE
  To determine the relative efficacy of RFA and antiarrhythmic drugs (AADs) on PVC burden reduction and increasing left ventricular systolic function.
  
  
  METHODS
  Patients with frequent PVCs (>1000/24 h) were treated either by RFA or with AADs from January 2005 through December 2010. Data from 24-hour Holter monitoring and echocardiography before and 6-12 months after treatment were compared between the 2 groups.
  
  
  RESULTS
  Of 510 patients identified, 215 (40%) underwent RFA and 295 (60%) received AADs. The reduction in PVC frequency was greater by RFA than with AADs (-21,799/24 h vs -8,376/24 h; P < .001). The left ventricular ejection fraction (LVEF) was increased significantly after RFA (53%-56%; P < .001) but not after AAD (52%- 52%; P = .6) therapy. Of 121 (24%) patients with reduced LVEF, 39 (32%) had LVEF normalization to 50% or greater. LVEF was restored in 25 of 53 (47%) patients in the RFA group compared with 14 of 68 (21%) patients in the AAD group (P = .003). PVC coupling interval less than 450 ms, less impaired left ventricular function, and RFA were independent predictors of LVEF normalization performed by using multivariate analysis.
  
  
  CONCLUSIONS
  RFA appears to be more effective than AADs in PVC reduction and LVEF normalization.
authors.affiliation: Department of Cardiology, Southwest Hospital, Third Military Medical University, Chongqing, People's Republic of China; Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota.
authors.forename: Li
authors.initials: L
authors.lastname: Zhong
authors.affiliation: Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota; Cardiovascular Medicine, Mackay Memorial Hospital, Taipei, Taiwan.
authors.forename: Ying-Hsiang
authors.initials: YH
authors.lastname: Lee
authors.affiliation: Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota; Department of Cardiovascular Diseases, Changhai Hospital, Second Military Medical University, Shanghai, People's Republic of China.
authors.forename: Xin-Miao
authors.initials: XM
authors.lastname: Huang
authors.affiliation: Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota.
authors.forename: Samuel J
authors.initials: SJ
authors.lastname: Asirvatham
authors.affiliation: Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota.
authors.forename: Win-Kuang
authors.initials: WK
authors.lastname: Shen
authors.affiliation: Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota.
authors.forename: Paul A
authors.initials: PA
authors.lastname: Friedman
authors.affiliation: Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester.
authors.forename: David O
authors.initials: DO
authors.lastname: Hodge
authors.affiliation: Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester.
authors.forename: Joshua P
authors.initials: JP
authors.lastname: Slusser
authors.affiliation: Department of Cardiology, Southwest Hospital, Third Military Medical University, Chongqing, People's Republic of China. Electronic address: zysong2010@126.com.
authors.forename: Zhi-Yuan
authors.initials: ZY
authors.lastname: Song
authors.affiliation: Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota.
authors.forename: Douglas L
authors.initials: DL
authors.lastname: Packer
authors.affiliation: Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota. Electronic address: ycha@mayo.edu.
authors.forename: Yong-Mei
authors.initials: YM
authors.lastname: Cha
mesh_terms: D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D017115:Catheter Ablation; D004452:Echocardiography; D004562:Electrocardiography; D015716:Electrocardiography, Ambulatory; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D013318:Stroke Volume; D016896:Treatment Outcome; D018879:Ventricular Premature Complexes / Q000503:physiopathology / Q000628:therapy*
chemical_list: D000889:Anti-Arrhythmia Agents
keywords: AAD; Antiarrhythmic drug; CAD; CCB; DCM; ECG; ICM; LV; LVEDD; LVEF; LVESD; LVOT; Left ventricular dysfunction; NSVT; PVC; PVC-CMP; Premature ventricular contraction; Premature ventricular contraction–induced cardiomyopathy; RFA; RV; RVOT; Radiofrequency catheter ablation; antiarrhythmic drug; calcium channel blocker; coronary artery disease; dilated cardiomyopathy; electrocardiogram; ischemic cardiomyopathy; left ventricular ejection fraction; left ventricular end-diastolic dimension; left ventricular end-systolic dimension; left ventricular outflow tract; left ventricular/ventricle; nonsustained ventricular tachycardia; premature ventricular contraction; premature ventricular contraction–induced cardiomyopathy; radiofrequency ablation; right ventricular outflow tract; right ventricular/ventricle