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Advances in management of premature ventricular contractions

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Abstract

Premature ventricular complexes (PVCs) are a common occurrence in clinical practice. The clinical presentation may range from asymptomatic to left ventricular (LV) dysfunction with congestive heart failure. The decision to suppress PVCs is largely based on the presence of symptoms, interference with other therapy (e.g., cardiac resynchronization therapy), or suspicion of PVC-mediated cardiomyopathy. Catheter ablation has emerged as a safe and effective option for the treatment of frequent PVCs. Careful attention to PVC characteristics on surface electrocardiogram has proven useful for the initial localization of the ectopic focus, which may then serve as a guide to procedural planning. The point of interest is often identified with activation mapping, and the ablation site can be further defined with pace mapping techniques. Clinical experience with PVC ablation has been successful in ≥80 % of cases, and the literature reports multiple cases of marked improvement in LV function after eradicating the culprit ectopic focus in patients with PVC-mediated cardiomyopathy.

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Abbreviations

DP:

Discrete potential

ECG:

Electrocardiogram

ICE:

Intracardiac echocardiography

LV:

Left ventricular

LVOT:

Left ventricular outflow tract

PVC:

Premature ventricular complex

RFA:

Radiofrequency ablation

RVOT:

Right ventricular outflow tract

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  1. Division of Cardiovascular Diseases (JCA, KS, WKS), Mayo Clinic, 5777 East Mayo Boulevard, Phoenix, AZ, 85054, USA

    Jonathon C. Adams, Komandoor Srivathsan & Win K. Shen

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  1. Jonathon C. Adams
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  2. Komandoor Srivathsan
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Correspondence to Win K. Shen.

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Adams, J.C., Srivathsan, K. & Shen, W.K. Advances in management of premature ventricular contractions. J Interv Card Electrophysiol 35, 137–149 (2012). https://doi.org/10.1007/s10840-012-9698-x

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