Background: Frequent premature ventricular contractions (PVC) can result in PVCinduced
cardiomyopathy (PVC-iCMP), leading to reduced Left Ventricular Ejection Fraction
(LVEF) that can be improved by radiofrequency catheter ablation (RFCA). We performed a systematic
review to determine the variables predicting LVEF improvement after RFCA in PVCiCMP.
Methods: We developed a “population, intervention, outcome and predictive factors” framework
and searched MEDLINE, Embase, Cochrane Library, Cochrane Collaboration and Cochrane Database
of Systematic Reviews (CDSR) for full-text, peer-reviewed publications. These publications
addressing predictive factors of LVEF improvement showed ≥5% improvement only if deemed
significant by the respective study, ≥10% or ≥ 50% after RFCA ablation in patients with PVCiCMP
with no type/date/language limitation until the end of 2017.
Results: Our initial search yielded 2226 titles, 1519 of which remained after removing the duplicates.
Finally, 11 articles - 2 cohorts, 7 quasi-experimental studies, 1 case-control and 1 metaanalysis-
were included. Sustained successful ablation, higher baseline PVC burden, LVEF, QRS
duration, post-PVC systolic blood pressure rise and post-PVC pulse pressure change, the absence of
an underlying cardiomyopathy, younger age, and variability of the frequency of PVCs during the
day and lower left ventricular end-diastolic diameter (LVEDD) have been suggested as predictive
factors for LVEF improvement in patients with PVC-iCMP.
Conclusion: The mentioned factors may all be useful to identify PVC-iCMP patients who would
benefit from RFCA, although the evidence is not yet strong enough.