title: Effect of ablation of frequent premature ventricular complexes on left ventricular function in patients with nonischemic cardiomyopathy.
abstract: BACKGROUND
  Frequent idiopathic premature ventricular complexes (PVCs) can result in PVC-induced cardiomyopathy. Frequent PVCs can also aggravate ischemic cardiomyopathy.
  
  
  OBJECTIVE
  The purpose of this study was to investigate the impact of frequent PVCs on nonischemic cardiomyopathy.
  
  
  METHODS
  This was a consecutive series of 30 patients (mean age 59.1 ± 12.1; 18 men; mean ejection fraction [EF] 38% ± 15%) with structurally abnormal hearts based on the presence of scar on cardiac magnetic resonance imaging and/or a history of cardiomyopathy before the presence of frequent PVCs who were referred for ablation of frequent PVCs.
  
  
  RESULTS
  Ablation was successful in 18 of 30 patients (60%), resulting in an increase of mean EF from 33.9% ± 14.5% to 45.7% ± 17% (P < .0001) during mean follow-up of 30 ± 28 months. The PVC burden in these patients was reduced from 23.1% ± 8.8% to 1.0% ± 0.9% (P < .0001). Mean EF did not change in patients with a failed ablation procedure (44.4 ± 16 vs 43.5 ± 21, P = .85). The PVC site of origin was in scar tissue in 14 of 18 patients with a successful ablation procedure. Mean New York Heart Association functional class improved from 2.3 ± 0.6 to 1.1 ± 0.2 (P < .0001) in patients with a successful outcome and remained unchanged in patients with an unsuccessful outcome (1.9 ± 0.9 vs 1.9 ± 0.7, P = 1).
  
  
  CONCLUSIONS
  In patients with frequent PVCs and nonischemic cardiomyopathy, EF and functional class can be improved but not always normalized by successful PVC ablation. In most patients with an effective ablation, the arrhythmogenic substrate was located in scar tissue.
authors.affiliation: Department of Cardiology, University of Michigan Health System, Ann Arbor, Michigan.
authors.forename: Moutaz
authors.initials: M
authors.lastname: El Kadri
authors.affiliation: Department of Cardiology, University of Michigan Health System, Ann Arbor, Michigan.
authors.forename: Miki
authors.initials: M
authors.lastname: Yokokawa
authors.affiliation: Department of Cardiology, University of Michigan Health System, Ann Arbor, Michigan.
authors.forename: Troy
authors.initials: T
authors.lastname: Labounty
authors.affiliation: Department of Radiology, University of Michigan Health System, Ann Arbor, Michigan.
authors.forename: Gisela
authors.initials: G
authors.lastname: Mueller
authors.affiliation: Department of Cardiology, University of Michigan Health System, Ann Arbor, Michigan.
authors.forename: Thomas
authors.initials: T
authors.lastname: Crawford
authors.affiliation: Department of Cardiology, University of Michigan Health System, Ann Arbor, Michigan.
authors.forename: Eric
authors.initials: E
authors.lastname: Good
authors.affiliation: Department of Cardiology, University of Michigan Health System, Ann Arbor, Michigan.
authors.forename: Krit
authors.initials: K
authors.lastname: Jongnarangsin
authors.affiliation: Department of Cardiology, University of Michigan Health System, Ann Arbor, Michigan.
authors.forename: Aman
authors.initials: A
authors.lastname: Chugh
authors.affiliation: Department of Cardiology, University of Michigan Health System, Ann Arbor, Michigan.
authors.forename: Hamid
authors.initials: H
authors.lastname: Ghanbari
authors.affiliation: Department of Cardiology, University of Michigan Health System, Ann Arbor, Michigan.
authors.forename: Rakesh
authors.initials: R
authors.lastname: Latchamsetty
authors.affiliation: Department of Cardiology, University of Michigan Health System, Ann Arbor, Michigan.
authors.forename: Hakan
authors.initials: H
authors.lastname: Oral
authors.affiliation: Department of Cardiology, University of Michigan Health System, Ann Arbor, Michigan.
authors.forename: Frank
authors.initials: F
authors.lastname: Pelosi
authors.affiliation: Department of Cardiology, University of Michigan Health System, Ann Arbor, Michigan.
authors.forename: Fred
authors.initials: F
authors.lastname: Morady
authors.affiliation: Department of Cardiology, University of Michigan Health System, Ann Arbor, Michigan. Electronic address: fbogun@med.umich.edu.
authors.forename: Frank
authors.initials: F
authors.lastname: Bogun
mesh_terms: D000368:Aged; D009202:Cardiomyopathies / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology; D017115:Catheter Ablation / Q000009:adverse effects / Q000379:methods; D002921:Cicatrix / Q000209:etiology; D015716:Electrocardiography, Ambulatory / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D013318:Stroke Volume; D014481:United States; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis / Q000209:etiology; D016277:Ventricular Function, Left; D018879:Ventricular Premature Complexes / Q000175:diagnosis / Q000209:etiology / Q000601:surgery
keywords: Ablation; Nonischemic cardiomyopathy; Premature ventricular complex