Risk stratification in patients with frequent premature ventricular complexes in the absence of known heart disease.
Female
Heart Diseases
Heart Ventricles
/ diagnostic imaging
Humans
Incidence
Magnetic Resonance Imaging, Cine
/ methods
Male
Middle Aged
Myocardium
/ pathology
Retrospective Studies
Risk Assessment
/ methods
Stroke Volume
/ physiology
United States
/ epidemiology
Ventricular Function, Left
/ physiology
Ventricular Premature Complexes
/ epidemiology
Catheter ablation
Delayed enhancement cardiac magnetic resonance imaging
Premature ventricular complex
Programmed ventricular stimulation
Risk stratification
Journal
Heart rhythm
ISSN: 1556-3871
Titre abrégé: Heart Rhythm
Pays: United States
ID NLM: 101200317
Informations de publication
Date de publication:
03 2020
03 2020
Historique:
received:
10
08
2019
pubmed:
4
10
2019
medline:
6
5
2021
entrez:
4
10
2019
Statut:
ppublish
Résumé
Frequent premature ventricular complexes (PVCs) can be an indicator of structural heart disease. The purpose of this study was to determine the prevalence of scarring detected by delayed enhancement cardiac magnetic resonance (DE-CMR) imaging in patients with frequent PVCs without apparent structural heart disease and to determine the value of programmed ventricular stimulation (PVS) for risk stratification in patients with frequent PVCs and myocardial scarring. DE-CMR imaging was performed in patients without apparent heart disease who had frequent PVCs and were referred for ablation. In the presence of scarring, scar volume was measured and correlated with outcome variables. All patients underwent PVS and were monitored for the occurrence of ventricular arrhythmias. Logistic regression was used to compare imaging and procedural findings with long-term outcomes, with adjustment for postablation ejection fraction (EF). The study consisted of 272 patients (135 men; mean age 52 ± 15 years; EF 52% ± 12%). DE-CMR scar was found in 67 patients (25%), and 7 (3%) were found to have inducible ventricular tachycardia (VT). The presence and amount of DE-CMR were related to the risk of long-term VT independent of EF (hazard ratio 18.8 [95% confidence interval] [2.0-176.6], P = .01; and hazard ratio 1.4 [1.1-1.7] per cm Preprocedural cardiac DE-CMR and PVS can be used to identify patients with frequent PVCs without apparent heart disease who are at risk for VT.
Sections du résumé
BACKGROUND
Frequent premature ventricular complexes (PVCs) can be an indicator of structural heart disease.
OBJECTIVE
The purpose of this study was to determine the prevalence of scarring detected by delayed enhancement cardiac magnetic resonance (DE-CMR) imaging in patients with frequent PVCs without apparent structural heart disease and to determine the value of programmed ventricular stimulation (PVS) for risk stratification in patients with frequent PVCs and myocardial scarring.
METHODS
DE-CMR imaging was performed in patients without apparent heart disease who had frequent PVCs and were referred for ablation. In the presence of scarring, scar volume was measured and correlated with outcome variables. All patients underwent PVS and were monitored for the occurrence of ventricular arrhythmias. Logistic regression was used to compare imaging and procedural findings with long-term outcomes, with adjustment for postablation ejection fraction (EF).
RESULTS
The study consisted of 272 patients (135 men; mean age 52 ± 15 years; EF 52% ± 12%). DE-CMR scar was found in 67 patients (25%), and 7 (3%) were found to have inducible ventricular tachycardia (VT). The presence and amount of DE-CMR were related to the risk of long-term VT independent of EF (hazard ratio 18.8 [95% confidence interval] [2.0-176.6], P = .01; and hazard ratio 1.4 [1.1-1.7] per cm
CONCLUSION
Preprocedural cardiac DE-CMR and PVS can be used to identify patients with frequent PVCs without apparent heart disease who are at risk for VT.
Identifiants
pubmed: 31580899
pii: S1547-5271(19)30902-6
doi: 10.1016/j.hrthm.2019.09.027
pii:
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
423-430Informations de copyright
Copyright © 2019 Heart Rhythm Society. All rights reserved.