Journal article
A New Combined Parameter to Predict Premature Ventricular Complexes Induced Cardiomyopathy: Impact and Recognition of Epicardial Origin
Journal of cardiovascular electrophysiology, Vol.27(6), pp.709-717
06/01/2016
DOI: 10.1111/jce.12967
PMID: 26924618
Abstract
Predict the Impact of PVC on Myocardial Function
IntroductionReversible premature ventricular complexes-induced cardiomyopathy (PVC-CMP) is a well-described, multi-factorial entity. Single predictors, such as PVC burden or QRS duration, may not apply equally to all patients in contemporary unselected populations including patients with structural heart disease (SHD) or with particular origin such as epicardial (EPI) PVC. We sought to evaluate clinical criteria associated with PVC-CMP notably focusing on the EPI origin impact and ECG recognition and the value of a new composite predictor of PVC-CMP, the PVC-CMP-Index.
Methods and ResultsWe studied 107 consecutive patients (69 men; mean age = 56 16 years) with frequent PVC (23.1 +/- 11.5%) referred for PVC ablation. Thirty-six patients (33.6%) had an underlying SHD and 25 patients (23.4%) an EPI PVC origin. After a mean follow-up of 22.7 +/- 15.3 months, 72.9% achieved a long-term successful ablation and 54.2% had PVC-CMP. PVC-CMP prevalence was significantly higher in patients with an EPI compared to endocardial PVC focus (84.0% vs. 45.1%, respectively, P < 0.001). EPI PVC origin (OR = 68.7 IC95% [3.5-1363], P = 0.005), as well as SHD (OR = 12.3 IC95% [1.6-92.6], P = 0.015), was independent predictor of PVC-CMP. While PVC burden (AUC = 0.78) or PVC-QRS width (AUC = 0.68) independently predicted PVC-CMP, the PVC-CMP-Index (values 39) defined as: PVC burden (0-1) x PVC-QRS width (milliseconds) x a constant C (1.28 for SHD or 2 for ECG suggesting EPI origin based on our ECG 3-step algorithm), highly correlated with PVC-CMP (AUC = 0.91, sensitivity = 93%, specificity = 80%).
ConclusionWe developed a new index, which incorporates PVC burden, QRS width, and presence of SHD or suspected EPI origin that best predicted PVC-CMP.
Details
- Title: Subtitle
- A New Combined Parameter to Predict Premature Ventricular Complexes Induced Cardiomyopathy: Impact and Recognition of Epicardial Origin
- Creators
- David Hamon - Assistance Publique – Hôpitaux de ParisMarie Sadron Blaye-Felice - Hôpital RangueilJason S. Bradfield - University of California, Los AngelesNajia Chaachoui - Assistance Publique – Hôpitaux de ParisRoderick Tung - University of California, Los AngelesClaude S. Elayi - University of KentuckyMarmar Vaseghi - University of California, Los AngelesTarvinder S. Dhanjal - Assistance Publique – Hôpitaux de ParisNoel G. Boyle - University of California, Los AngelesPhilippe Maury - Hôpital RangueilKalyanam Shivkumar - University of California, Los AngelesNicolas Lellouche - Assistance Publique – Hôpitaux de Paris
- Resource Type
- Journal article
- Publication Details
- Journal of cardiovascular electrophysiology, Vol.27(6), pp.709-717
- Publisher
- Wiley
- DOI
- 10.1111/jce.12967
- PMID
- 26924618
- ISSN
- 1045-3873
- eISSN
- 1540-8167
- Number of pages
- 9
- Grant note
- Federation Francaise de Cardiologie
- Language
- English
- Date published
- 06/01/2016
- Academic Unit
- Internal Medicine
- Record Identifier
- 9984691512302771
Metrics
13 Record Views