A Review of the Potential Pathogenicity and Management Of Frequent Premature Ventricular Contractions.

Related Articles

A Review of the Potential Pathogenicity and Management Of Frequent Premature Ventricular Contractions.

Pacing Clin Electrophysiol. 2016 Apr 13;

Authors: Laplante L, Benzaquen BS

Abstract
Very frequent premature ventricular complexes (PVC's) may be a reversible cause of dilated cardiomyopathy. Literature on this largely unrecognized entity has increased in the last fifteen years. This paper reviews the literature on the consequences of frequent PVCs on myocardial function and management of PVC associated cardiomyopathy. The authors reviewed articles published in English before June 2015 describing pathophysiology, risk factors, symptoms, time course, treatment and outcome of cardiomyopathy associated with PVCs. The search was conducted using Medline and Embase. Key words included: cardiomyopathy, catheter ablation, antiarrhythmic drug, pathophysiology and ventricular premature contractions or synonyms. PVC associated cardiomyopathy is associated with a high burden of PVC (over 20% of heart beats). Other risk factors include electrophysiological characteristics, such as PVC QRS width, presence of ventricular tachycardia, retrograde P waves, interpolation, polymorphic PVCs and longer coupling intervals. Symptoms include palpitations, light-headedness, dyspnea, cough and dysphagia. The systolic dysfunction and chamber dilatation progresses over of a few years. Once the PVCs are suppressed by radiofrequency ablation or antiarrhythmic drugs, the cardiomyopathy usually resolves within six months. The pathophysiology remains unknown, but hypotheses mainly include ventricular dyssynchrony resulting in hemodynamic disturbances and abnormalities in calcium handling and oxygen consumption. PVC associated cardiomyopathy remains a largely unrecognized entity. It is a reversible cause of dilated cardiomyopathy that results from abnormal calcium and oxygen handling within the myocyte, dyssynchrony and hemodynamic compromise from inefficient heart beats. Suppression of the PVCs improves myocardial function, cardiac chamber sizes and patient's symptoms. This article is protected by copyright. All rights reserved.

PMID: 27073007 [PubMed - as supplied by publisher]

from #ENT via xlomafota13 on Inoreader http://ift.tt/1V3gvcV
via IFTTT