Premature ventricular complexes (PVC)-induced cardiomyopathy: A review and meta-analysis of pathophysiology, diagnosis and clinical management

Abstract

Frequent premature ventricular complexes (PVC) is a common cardiac entity in patients with structural heart disease and PVC-induced cardiomyopathy (PICM). It is also common in asymptomatic patients, where it is considered a benign entity with no prognostic implications. In patients with structural heart disease, the presence of PVCs can result in fatal ventricular arrhythmias. Various cellular and extracellular mechanism as well as risk factors for developing PICM have been suggested but the exact mechanisms remains unclear. The increasing insights into the treatment of ventricular tachyarrhythmias, especially the introduction of radiofrequency catheter ablation in clinical practice has renewed interest in PVCs as predictors of arrhythmias as well as their potential aetiological association with CM. The present paper reviews existing evidence on PICM patients with a focus on prevalence, risk factors, pathophysiology, clinical presentation, concluding with and a meta-analysis and discussion of current diagnostic and treatment criteria.

Premature Ventricular Contractions and Atrial Fibrillation: The Reunion of Distant Relatives?

“…It is now well established that a high burden of PVCs is linked to an increased risk of cardiomyopathy and that suppression of PVCs leads to improvement in left ventricular function. 2 , 3 , 4 Given ongoing advancements in digital health, the diagnosis of AF and the quantification of PVCs using continuous monitoring has been improved and simplified. Additionally, our heightened ability to treat both AF and PVCs safely using advanced three‐dimensional mapping technologies and radiofrequency ablation has reshaped the field of electrophysiology and improved outcomes for patients with all arrhythmias.…”