Li Zhong1, Ying-Hsiang Lee2, Xin-Miao Huang3, Samuel J Asirvatham4, Win-Kuang Shen4, Paul A Friedman4, David O Hodge5, Joshua P Slusser5, Zhi-Yuan Song6, Douglas L Packer4, Yong-Mei Cha7. 1. Department of Cardiology, Southwest Hospital, Third Military Medical University, Chongqing, People's Republic of China; Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota. 2. Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota; Cardiovascular Medicine, Mackay Memorial Hospital, Taipei, Taiwan. 3. Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota; Department of Cardiovascular Diseases, Changhai Hospital, Second Military Medical University, Shanghai, People's Republic of China. 4. Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota. 5. Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester. 6. Department of Cardiology, Southwest Hospital, Third Military Medical University, Chongqing, People's Republic of China. Electronic address: zysong2010@126.com. 7. Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota. Electronic address: ycha@mayo.edu.
Abstract
BACKGROUND: It is unknown whether radiofrequency ablation (RFA) or antiarrhythmic therapy is superior when treating patients with symptomatic premature ventricular contractions (PVCs). OBJECTIVE: To determine the relative efficacy of RFA and antiarrhythmic drugs (AADs) on PVC burden reduction and increasing left ventricular systolic function. METHODS: Patients with frequent PVCs (>1000/24 h) were treated either by RFA or with AADs from January 2005 through December 2010. Data from 24-hour Holter monitoring and echocardiography before and 6-12 months after treatment were compared between the 2 groups. RESULTS: Of 510 patients identified, 215 (40%) underwent RFA and 295 (60%) received AADs. The reduction in PVC frequency was greater by RFA than with AADs (-21,799/24 h vs -8,376/24 h; P < .001). The left ventricular ejection fraction (LVEF) was increased significantly after RFA (53%-56%; P < .001) but not after AAD (52%- 52%; P = .6) therapy. Of 121 (24%) patients with reduced LVEF, 39 (32%) had LVEF normalization to 50% or greater. LVEF was restored in 25 of 53 (47%) patients in the RFA group compared with 14 of 68 (21%) patients in the AAD group (P = .003). PVC coupling interval less than 450 ms, less impaired left ventricular function, and RFA were independent predictors of LVEF normalization performed by using multivariate analysis. CONCLUSION: RFA appears to be more effective than AADs in PVC reduction and LVEF normalization.
BACKGROUND: It is unknown whether radiofrequency ablation (RFA) or antiarrhythmic therapy is superior when treating patients with symptomatic premature ventricular contractions (PVCs). OBJECTIVE: To determine the relative efficacy of RFA and antiarrhythmic drugs (AADs) on PVC burden reduction and increasing left ventricular systolic function. METHODS:Patients with frequent PVCs (>1000/24 h) were treated either by RFA or with AADs from January 2005 through December 2010. Data from 24-hour Holter monitoring and echocardiography before and 6-12 months after treatment were compared between the 2 groups. RESULTS: Of 510 patients identified, 215 (40%) underwent RFA and 295 (60%) received AADs. The reduction in PVC frequency was greater by RFA than with AADs (-21,799/24 h vs -8,376/24 h; P < .001). The left ventricular ejection fraction (LVEF) was increased significantly after RFA (53%-56%; P < .001) but not after AAD (52%- 52%; P = .6) therapy. Of 121 (24%) patients with reduced LVEF, 39 (32%) had LVEF normalization to 50% or greater. LVEF was restored in 25 of 53 (47%) patients in the RFA group compared with 14 of 68 (21%) patients in the AAD group (P = .003). PVC coupling interval less than 450 ms, less impaired left ventricular function, and RFA were independent predictors of LVEF normalization performed by using multivariate analysis. CONCLUSION: RFA appears to be more effective than AADs in PVC reduction and LVEF normalization.
Authors: Edmond M Cronin; Frank M Bogun; Philippe Maury; Petr Peichl; Minglong Chen; Narayanan Namboodiri; Luis Aguinaga; Luiz Roberto Leite; Sana M Al-Khatib; Elad Anter; Antonio Berruezo; David J Callans; Mina K Chung; Phillip Cuculich; Andre d'Avila; Barbara J Deal; Paolo Della Bella; Thomas Deneke; Timm-Michael Dickfeld; Claudio Hadid; Haris M Haqqani; G Neal Kay; Rakesh Latchamsetty; Francis Marchlinski; John M Miller; Akihiko Nogami; Akash R Patel; Rajeev Kumar Pathak; Luis C Saenz Morales; Pasquale Santangeli; John L Sapp; Andrea Sarkozy; Kyoko Soejima; William G Stevenson; Usha B Tedrow; Wendy S Tzou; Niraj Varma; Katja Zeppenfeld Journal: J Interv Card Electrophysiol Date: 2020-10 Impact factor: 1.900
Authors: S Fichtner; J Senges; M Hochadel; R Tilz; S Willems; L Eckardt; T Deneke; T Lewalter; U Dorwarth; C Reithmann; J Brachmann; G Steinbeck; S Kääb Journal: Clin Res Cardiol Date: 2016-08-02 Impact factor: 5.460