title: Recurrence of PVCs in patients with PVC-induced cardiomyopathy.
abstract: BACKGROUND
  The natural history of premature ventricular complex (PVC)-induced cardiomyopathy is incompletely understood.
  
  
  OBJECTIVE
  The purpose of this study was to assess long term follow-up data in patients who underwent successful PVC ablation for PVC-induced cardiomyopathy.
  
  
  METHODS
  The subjects of this study were 60 patients (17 women; mean age 52.5 ± 16.8 years; ejection fraction [EF] 37.3 ± 8.5%, median 40%, interquartile range [IQR] 15) with PVC-induced cardiomyopathy who underwent successful ablation of their predominant PVCs between 2005 and 2012. Patients were followed up for a mean of 23.6 ± 17.2 months. EF improved to 57.2 ± 4.7% (median 55%, IQR 5; P = .0001) within 9.6 ± 8.4 months of the ablation procedure. During follow-up, 10 of 60 patients (16.7%) had recurrent frequent PVCs and 50 patients (83.3%) did not. Patients underwent repeat assessment of EF and PVC burden.
  
  
  RESULTS
  During follow-up of 23.6 ± 17.2 months, 10 patients had recurrent frequent PVCs, with an increase of their PVC burden from 1.4 ± 0.9% (median 1.05%, IQR 1.59) after the initial ablation to 27.2 ± 8.8% (median 26.0%, IQR 18.2; P = .018). Their EF decreased from 55.7 ± 3.4% (median 55%, IQR 5.8) after the initial ablation to 40.2 ± 5.1% (median 40%, IQR 15; P = .005). In the remaining patients with PVC-induced cardiomyopathy, EF and PVC burden remained unchanged during follow-up. Patients with PVC recurrence had a higher number of pleomorphic PVC morphologies during initial presentation (4.7 ± 2.2 vs 2.5 ± 2.8, P = .002).
  
  
  CONCLUSIONS
  Recurrence of frequent PVCs in patients with a history of PVC cardiomyopathy can result in recurrence of cardiomyopathy. Follow-up in patients with PVC-induced cardiomyopathy is important, especially if patients were asymptomatic from the PVCs and have pleomorphic PVCs.
authors: Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, Michigan.
authors: Kazim
authors: K
authors: Baser
authors: Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, Michigan.
authors: Hatice Duygu
authors: HD
authors: Bas
authors: Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, Michigan.
authors: Troy
authors: T
authors: LaBounty
authors: Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, Michigan.
authors: Miki
authors: M
authors: Yokokawa
authors: Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, Michigan.
authors: Eric
authors: E
authors: Good
authors: Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, Michigan.
authors: Rakesh
authors: R
authors: Latchamsetty
authors: Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, Michigan.
authors: Fred
authors: F
authors: Morady
authors: Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, Michigan. Electronic address: fbogun@med.umich.edu.
authors: Frank
authors: F
authors: Bogun
mesh_terms: D000328:Adult; D000368:Aged; D009202:Cardiomyopathies / Q000150:complications / Q000503:physiopathology; D017115:Catheter Ablation / Q000009:adverse effects / Q000379:methods; D015716:Electrocardiography, Ambulatory / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008824:Michigan; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis / Q000517:prevention & control; D012008:Recurrence; D013318:Stroke Volume; D018487:Ventricular Dysfunction, Left / Q000150:complications / Q000503:physiopathology; D018879:Ventricular Premature Complexes / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000601:surgery
keywords: PVCs; ablation; cardiomyopathy