title: Identifying and Managing Premature Ventricular Contraction-Induced Cardiomyopathy: What, Why, and How?
abstract: Premature ventricular contraction (PVC)-induced cardiomyopathy is increasingly being recognized as a reversible cause of left ventricular (LV) systolic dysfunction (LVSD). The diagnosis of PVC-induced cardiomyopathy is considered in subjects with high PVC burdens (> 10,000 per 24 hours) after excluding other known causes of LVSD. PVC suppression is the mainstay of the management of PVC-induced cardiomyopathy, in addition to proven evidence-based medical therapy recommended for subjects with LVSD. Management strategies for PVC-induced cardiomyopathy include medical therapy and/or catheter ablation, with an increasing role for catheter ablation as a first-line therapy in view of the potential for permanent suppression of PVCs. Recovery of LVSD is typically a gradual process over months after effective suppression of PVCs. Last, asymptomatic patients with high PVC burdens and preserved LV systolic function appear to be at low risk over the intermediate term for developing LVSD. However, it is prudent to monitor LV function periodically because of the potential for deterioration of LV function observed during long-term follow-up in some subjects.
authors.affiliation: Arrhythmia Service, Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada. Electronic address: wael011@hotmail.com.
authors.forename: Wael A
authors.initials: WA
authors.lastname: Alqarawi
authors.affiliation: Arrhythmia Service, Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
authors.forename: F Daniel
authors.initials: FD
authors.lastname: Ramirez
authors.affiliation: Arrhythmia Service, Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
authors.forename: Pablo B
authors.initials: PB
authors.lastname: Nery
authors.affiliation: Arrhythmia Service, Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
authors.forename: Calum J
authors.initials: CJ
authors.lastname: Redpath
authors.affiliation: Arrhythmia Service, Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
authors.forename: Mouhannad M
authors.initials: MM
authors.lastname: Sadek
authors.affiliation: Arrhythmia Service, Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
authors.forename: Martin S
authors.initials: MS
authors.lastname: Green
authors.affiliation: Arrhythmia Service, Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
authors.forename: David H
authors.initials: DH
authors.lastname: Birnie
authors.affiliation: Arrhythmia Service, Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
authors.forename: Girish M
authors.initials: GM
authors.lastname: Nair
mesh_terms: D009202:Cardiomyopathies / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D003937:Diagnosis, Differential; D019468:Disease Management; D004452:Echocardiography; D015716:Electrocardiography, Ambulatory; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction; D013318:Stroke Volume / Q000502:physiology*; D013599:Systole; D013997:Time Factors; D018487:Ventricular Dysfunction, Left / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D018879:Ventricular Premature Complexes / Q000150:complications* / Q000175:diagnosis / Q000628:therapy