Predictors of recovery of left ventricular dysfunction after ablation of frequent ventricular premature depolarizations

Marc W. Deyell, Kyoung Min Park, Yuchi Han, David S. Frankel, Sanjay Dixit, Joshua M. Cooper, Mathew D. Hutchinson, David Lin, Fermin Garcia, Rupa Bala, Michael P. Riley, Edward Gerstenfeld, David J. Callans, Francis E. Marchlinski

Research output: Contribution to journalArticle

77 Scopus citations

Abstract

Frequent ventricular premature depolarizations (VPDs) can cause reversible left ventricular (LV) dysfunction. However, not all patients normalize their LV function after VPD elimination. To evaluate predictors of recovery of LV function following the elimination of frequent VPDs. We identified patients with <10% VPDs/24 h and an LV ejection fraction of <50% who underwent successful ablation between 2007 and 2011. Subjects were classified as having reversible (<10% increase to a final LV ejection fraction of <50%) or irreversible (≤10% increase or final LV ejection fraction <50%) LV dysfunction on the basis of echocardiographic follow-up. A reference group with <10% VPDs but normal LV function was identified. One hundred fourteen patients with <10% VPDs were identified; 66 had preserved and 48 had impaired LV function. Over a median follow-up of 10.6 months, 24 of 48 were classified as reversible and 13 of 48 as irreversible and 11 of 44 were excluded. There was a gradient of VPD QRS duration between the control, reversible, and irreversible groups (mean VPD QRS 135, 158, and 173 ms, respectively; P < .001). This gradient persisted even for the same site of origin. In multivariate analysis, the only independent predictor of irreversible LV function was VPD QRS duration (odds ratio 5.07 [95% confidence interval 1.2221.01] per 10-ms increase). In patients with LV dysfunction and frequent VPDs, we identified VPD QRS duration as the only independent predictor for the recovery of LV function after ablation. This suggests that VPD QRS duration may be a marker for the severity of underlying substrate abnormality.

Original languageEnglish (US)
Pages (from-to)1465-1472
Number of pages8
JournalHeart Rhythm
Volume9
Issue number9
DOIs
StatePublished - Sep 1 2012

Keywords

  • Cardiomyopathy
  • Catheter ablation
  • Electrocardiogram
  • Ventricular arrhythmia

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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    Deyell, M. W., Park, K. M., Han, Y., Frankel, D. S., Dixit, S., Cooper, J. M., Hutchinson, M. D., Lin, D., Garcia, F., Bala, R., Riley, M. P., Gerstenfeld, E., Callans, D. J., & Marchlinski, F. E. (2012). Predictors of recovery of left ventricular dysfunction after ablation of frequent ventricular premature depolarizations. Heart Rhythm, 9(9), 1465-1472. https://doi.org/10.1016/j.hrthm.2012.05.019