title: Reversal of left ventricular dysfunction after ablation of premature ventricular contractions related parameters, paradoxes and exceptions to the rule.
abstract: Suppression of frequent premature ventricular contractions (PVCs) does not systematically lead to an expected reversal of PVC-induced cardiomyopathy and determinants of left ventricular ejection fraction (LVEF) recovery (reverse remodeling) after ablation remain largely unknown.
  
  
  
  Ninety-six consecutive patients with a suspicion of PVC induced-cardiomyopathy were retrospectively included. Parameters potentially related to reverse remodeling (>10% increase in LVEF) were analyzed in patients w/wo long-term success (decrease in PVC burden >80%).
  
  
  
  Over a mean follow-up of 24±21months, long-term ablation success was obtained in 76 patients (79%). In these, reverse remodeling was observed in 63 (83%) (LVEF 39±8 to 56±8%, p<0.0001). In multivariate analysis, only an older age (and marginally a lower PVC QRS amplitude) was independently associated with the lack of reverse remodeling. Only 10 of the 35 patients who initially should have received an ICD for primary prevention remained candidates for implantation after ablation. Lack of reverse remodeling was significantly linked to a higher mortality.
  
  
  
  Reverse remodeling was observed in 83% of patients with frequent PVC and unexplained cardiomyopathy undergoing long-term successful ablation of the PVC. A younger age was independently correlated with the occurrence of reverse remodeling.
authors.affiliation: University Hospital Rangueil Toulouse, France.
authors.forename: Marie
authors.initials: M
authors.lastname: Sadron Blaye-Felice
authors.affiliation: University Hospital Mondor, Paris, France.
authors.forename: David
authors.initials: D
authors.lastname: Hamon
authors.affiliation: University Hospital Haut-Leveque, Bordeaux-Pessac, France.
authors.forename: Frederic
authors.initials: F
authors.lastname: Sacher
authors.affiliation: CHUV, Lausanne, Switzerland.
authors.forename: Patrizio
authors.initials: P
authors.lastname: Pascale
authors.affiliation: University Hospital Rangueil Toulouse, France.
authors.forename: Anne
authors.initials: A
authors.lastname: Rollin
authors.affiliation: University Hospital Rangueil Toulouse, France.
authors.forename: Vanina
authors.initials: V
authors.lastname: Bongard
authors.affiliation: University Hospital Rangueil Toulouse, France.
authors.forename: Alexandre
authors.initials: A
authors.lastname: Duparc
authors.affiliation: University Hospital Rangueil Toulouse, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Mondoly
authors.affiliation: University Hospital Haut-Leveque, Bordeaux-Pessac, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Derval
authors.affiliation: University Hospital Haut-Leveque, Bordeaux-Pessac, France.
authors.forename: Arnaud
authors.initials: A
authors.lastname: Denis
authors.affiliation: University Hospital Rangueil Toulouse, France.
authors.forename: Christelle
authors.initials: C
authors.lastname: Cardin
authors.affiliation: University Hospital Haut-Leveque, Bordeaux-Pessac, France.
authors.forename: Mélèze
authors.initials: M
authors.lastname: Hocini
authors.affiliation: University Hospital Haut-Leveque, Bordeaux-Pessac, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Jaïs
authors.affiliation: CHUV, Lausanne, Switzerland.
authors.forename: Etienne
authors.initials: E
authors.lastname: Pruvot
authors.affiliation: CHUV, Lausanne, Switzerland.
authors.forename: Jurg
authors.initials: J
authors.lastname: Schlaepfer
authors.affiliation: University Hospital Rangueil Toulouse, France.
authors.forename: Didier
authors.initials: D
authors.lastname: Carrié
authors.affiliation: University Hospital Rangueil Toulouse, France.
authors.forename: Michel
authors.initials: M
authors.lastname: Galinier
authors.affiliation: University Hospital Mondor, Paris, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Lellouche
authors.affiliation: University Hospital Haut-Leveque, Bordeaux-Pessac, France.
authors.forename: Michel
authors.initials: M
authors.lastname: Haïssaguerre
authors.affiliation: University Hospital Rangueil Toulouse, France. Electronic address: mauryjphil@hotmail.com.
authors.forename: Philippe
authors.initials: P
authors.lastname: Maury
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D009202:Cardiomyopathies / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D017115:Catheter Ablation / Q000009:adverse effects / Q000379:methods; D015716:Electrocardiography, Ambulatory / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D005602:France; D006801:Humans; D000069451:Long Term Adverse Effects / Q000175:diagnosis / Q000503:physiopathology / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D011183:Postoperative Complications / Q000175:diagnosis / Q000503:physiopathology / Q000517:prevention & control; D012307:Risk Factors; D018487:Ventricular Dysfunction, Left / Q000209:etiology / Q000503:physiopathology; D018879:Ventricular Premature Complexes / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery; D020257:Ventricular Remodeling / Q000502:physiology*
keywords: Ablation; Cardiomyopathy; Radiofrequency; Remodeling; Ventricular premature contraction