Effects of radiofrequency catheter ablation for premature ventricular complexes originating from the right ventricular outflow tract on right ventricular function

Abstract

Introduction This study aimed to elucidate the relationship between premature ventricular complexes (PVCs) and right ventricular (RV) dysfunction, and the effects of radiofrequency catheter ablation (RFCA) on RV function. Methods A total of 110 patients (age, 50.8 ± 14.4 years; 30 men) without structural heart disease who had undergone RFCA for RV outflow tract (RVOT) PVCs were retrospectively included. RV function was assessed using fractional area change (FAC) and global longitudinal strain (GLS) before and after RFCA. Clinical data were compared between the RV dysfunction (n = 63) and preserved RV function (n = 47) groups. The relationship between PVC burden and RV function was analyzed. Change in RV function before and after RFCA was compared between patients with successful and failed RFCA. Results PVC burden was significantly higher in the RV dysfunction group than in the preserved RV function group (p < .001). FAC and GLS were significantly worse in proportion to PVC burden (p < .001 and p < .001, respectively). The risk factor associated with RV dysfunction was PVC burden [odds ratio (95% confidence interval), 1.092 (1.052–1.134); p < .001]. Improvement in FAC (13.0 ± 8.7% and –2.5 ± 5.6%, respectively; p < .001) and GLS (–6.8 ± 5.7% and 2.1 ± 4.2%, respectively; p < .001) was significant in the patients with successful RFCA, compared to the patients in whom RFCA failed. Conclusions Frequent RVOT PVCs are associated with RV dysfunction. RV dysfunction is reversible by successful RFCA.

Assessment of subtle cardiac dysfunction induced by premature ventricular contraction using two dimensional strain echocardiography and the effects of successful ablation

“…In a recent study, Koca et al reported that RF ablation increased LV longitudinal strain values [22]. Again, Uhm et al showed the positive effect of RF ablation on RV-GLS in patients with frequent PVCs originating from RVOT [23]. Recent article also demonstrated impaired LV-GLS in the sinus rhythm beat preceding PVC.…”