Predictors of Left Ventricular Ejection Fraction Improvement after Radiofrequency Catheter Ablation in Patients with PVC-Induced Cardiomyopathy: A Systematic Review

Author(s): Farbod Z. Tajrishi, Mohammad H. Asgardoon, Amirhossein S. Hosseinpour, Alipasha Meysamie, Ali Vasheghani-Farahani*

Journal Name: Current Cardiology Reviews

Volume 16 , Issue 4 , 2020


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Abstract:

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.

Keywords: PVC-iCMP, catheter ablation, LVEF improvement, systematic review, prognosis, radiofrequency.

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Article Details

VOLUME: 16
ISSUE: 4
Year: 2020
Published on: 09 July, 2019
Page: [315 - 325]
Pages: 11
DOI: 10.2174/1573403X15666190710095248
Price: $65

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