title: Radiofrequency ablation can reverse the structural remodeling caused by frequent premature ventricular contractions originating from the right ventricular outflow tract even in a "normal heart".
abstract: OBJECTIVE
  The aim of this study was to evaluate whether frequent premature ventricular contractions originating from the right ventricular outflow tract remodel the cardiac structure and function in patients with a "seemingly normal heart" and whether radiofrequency ablation can reverse this remodeling.
  
  
  METHODS
  Sixty-eight patients with idiopathic frequent premature ventricular contractions originating from the right ventricular outflow tract and normal heart structure and function were enrolled in this study. The patients were divided into three groups according to the therapeutic method: radiofrequency ablation group (24 cases), anti-arrhythmia drug group (26 cases), and control group (18 cases without any treatment). Clinical Registration number: ChiCTR-ONRC-12002834 RESULTS: The basic patient characteristics were comparable between the three groups, except for the premature ventricular contraction rate, which was significantly lower in the control group. After six months of follow up, the premature ventricular contraction rate was significantly reduced in the radiofrequency ablation group, which was accompanied by a significant decrease in the following cardiac cavity inner diameters, as determined by echocardiography: right atrium (33.33±3.78 vs. 30.05±2.60 mm, p = 0.001), right ventricle (23.24±2.40 vs. 21.05±2.16 mm, p = 0.020), and left ventricle (44.76±4.33 vs. 41.71±3.44 mm, p = 0.025). These results were similar in the anti-arrhythmia drug group, although this group exhibited a smaller extent of change (right atrium: 33.94±3.25 vs. 31.27±3.11 mm, p = 0.024; right ventricle: 22.97±3.09 vs. 21.64±2.33 mm, p = 0.049; left ventricle: 45.92±6.38 vs. 43.84±5.67 mm, p = 0.039), but not in the control group (p>0.05). There was a tendency toward improvement in the cardiac functions in both the radiofrequency ablation and anti-arrhythmia drug groups. However, these differences were not statistically significant (p>0.05).
  
  
  CONCLUSIONS
  These results indicate that radiofrequency ablation can potentially reverse the cardiac remodeling caused by frequent premature ventricular contractions even in structurally normal hearts and that frequent premature ventricular contractions should be abated even in structurally normal hearts.
authors.affiliation: The Third Military Medical University, Chongqing Institute of Cardiology, Daping Hospital, Department of Cardiology, Chongqing, China.
authors.forename: Yuqiang
authors.initials: Y
authors.lastname: Fang
authors.forename: Chunlan
authors.initials: C
authors.lastname: Wen
authors.forename: Li
authors.initials: L
authors.lastname: Yang
authors.forename: Xiaoqun
authors.initials: X
authors.lastname: Zhang
authors.forename: Wei
authors.initials: W
authors.lastname: Chu
authors.forename: Chunyu
authors.initials: C
authors.lastname: Zeng
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D017115:Catheter Ablation / Q000379:methods*; D005260:Female; D006325:Heart Atria / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012016:Reference Values; D015203:Reproducibility of Results; D013997:Time Factors; D016896:Treatment Outcome; D016278:Ventricular Function, Right / Q000502:physiology*; D018879:Ventricular Premature Complexes / Q000503:physiopathology / Q000601:surgery*; D020257:Ventricular Remodeling / Q000502:physiology*; D055815:Young Adult
chemical_list: D000889:Anti-Arrhythmia Agents