Direct Intramyocardial Ethanol Injection for Premature Ventricular Contraction Arising From the Inaccessible Left Ventricular Summit

2021 ◽  
Author(s):  
Gurukripa N. Kowlgi ◽  
Arman Arghami ◽  
Juan A. Crestanello ◽  
Christopher J. François ◽  
Paul A. Friedman ◽  
...  
Keyword(s):  
Premature Ventricular Contraction ◽  
Left Ventricular ◽  
Ventricular Contraction ◽  
Ethanol Injection

Premature ventricular contraction-induced cardiomyopathy in children

2015 ◽  
Vol 26 (4) ◽  
pp. 711-717 ◽  
Author(s):  
Zebulon Z. Spector ◽  
Stephen P. Seslar
Keyword(s):  
Ventricular Tachycardia ◽  
Radiofrequency Ablation ◽  
Premature Ventricular Contraction ◽  
Structural Heart Disease ◽  
Left Ventricular ◽  
Ventricular Contraction ◽  
Premature Ventricular Contractions ◽  
Multi Centre Study ◽  
History Of

AbstractBackgroundAdults with high premature ventricular contraction burden can develop left ventricular dilation, dysfunction, and strain, consistent with a cardiomyopathy, which is reversible with radiofrequency ablation of the premature ventricular contractions. Evidence in children with similar ectopy burden is limited. We performed a single-centre retrospective review to examine the prevalence of premature ventricular contraction-induced cardiomyopathy, natural history of ventricular ectopy, and progression to ventricular tachycardia in children with frequent premature ventricular contractions.MethodsChildren aged between 6 months and 18 years, with premature ventricular contractions comprising at least 20% of rhythm on 24-hour Holter monitor, were included in our study. Those with significant structural heart disease, ventricular tachycardia greater than 1% of rhythm at the time of premature ventricular contraction diagnosis, or family history of cardiomyopathy – except tachycardia-induced – were excluded. Cardiomyopathy was defined by echocardiographic assessment.ResultsA total of 36 children met the study criteria; seven patients (19.4%, 95% CI 6.2–32.6%) met the criteria for cardiomyopathy, mostly at initial presentation. Ectopy decreased to <10% of beats without intervention in 16.7% (95% CI 4.3–29.1%) of the patients. No patient progressed to having ventricular tachycardia as more than 1% of beats on follow-up Holter. Radiofrequency ablation was performed in three patients without cardiomyopathy.ConclusionsOur study demonstrates a higher prevalence of cardiomyopathy among children with high premature ventricular contraction burden than that previously shown. Ectopy tended to persist throughout follow-up. These trends suggest the need for a multi-centre study on frequent premature ventricular contractions in children. In the interim, regular follow-up with imaging to evaluate for cardiomyopathy is warranted.

scholarly journals Left ventricular pseudoaneurysm as a complication of left ventricular summit premature ventricular contraction ablation

2017 ◽  
Vol 3 (5) ◽  
pp. 268-271 ◽  
Author(s):  
Sanjay Dandamudi ◽  
Susan S. Kim ◽  
Nishant Verma ◽  
S. Chris Malaisrie ◽  
Roderick Tung ◽  
...  
Keyword(s):  
Premature Ventricular Contraction ◽  
Left Ventricular ◽  
Ventricular Contraction ◽  
Left Ventricular Pseudoaneurysm

scholarly journals Premature Ventricular Contraction-induced Cardiomyopathy

2017 ◽  
Vol 6 (4) ◽  
pp. 153 ◽  
Author(s):  
David J Callans ◽  
Keyword(s):  
Ventricular Dysfunction ◽  
Differential Susceptibility ◽  
Premature Ventricular Contraction ◽  
Left Ventricular ◽  
Clinical Syndrome ◽  
Polymorphic Ventricular Tachycardia ◽  
Proper Treatment ◽  
Ventricular Contraction ◽  
Premature Ventricular Contractions ◽  
Antiarrhythmic Medications

Premature ventricular contractions (PVCs) are very common and usually do not require treatment. However, in the clinical setting of troublesome symptoms, or when PVCs trigger polymorphic ventricular tachycardia or cause cardiomyopathy, proper treatment is critical. In this review, the clinical syndrome of PVC-induced cardiomyopathy, including risk factors for development and treatment, is discussed. Although PVC-induced cardiomyopathy is typically associated with frequent PVCs there are also patients with this burden that do not develop cardiomyopathy, suggesting a differential susceptibility. Treatment often consists of catheter ablation, although antiarrhythmic medications may also provide both reduction in PVC frequency and resolution of left ventricular dysfunction.

scholarly journals Increased left ventricular stiffness assessed by diastolic wall strain causes symptoms in patients with premature ventricular contraction

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
E Fukuhara ◽  
T Mine ◽  
H Kishima ◽  
M Ishihara
Keyword(s):  
Natriuretic Peptide ◽  
Premature Ventricular Contraction ◽  
Structural Heart Disease ◽  
Posterior Wall ◽  
Left Ventricular ◽  
Ventricular Contraction ◽  
Echocardiographic Measurement ◽  
Left Ventricular Stiffness ◽  
Diastolic Wall Strain ◽  
Coupling Interval

Abstract Background Premature ventricular contraction (PVC) is one of common arrhythmias and only some patients complain of PVC-related symptoms, however the mechanisms which cause the symptoms remain unclear in patients with PVCs. Purpose We investigated whether the left ventricular (LV) stiffness assessed by diastolic wall strain (DWS) relate symptoms or not in patients with PVC. Methods We studied 109 patients (48 males, age 60±19) with frequent monomorphic PVCs who underwent 12-leads electrocardiogram (ECG), signal-averaged electrocardiogram (SAECG), 24h-Holter ECG recording, and transthoracic echocardiography (TTE). Patients with structural heart disease or other arrhythmias such as atrial fibrillation were excluded. Clinical factors, blood samples for atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP), and filtered QRS duration (f-QRS) and root mean square voltage of the terminal 40ms of the QRS complex (RMS40) obtained by SAECG were evaluated. We assessed PVC-SV (stroke volume during PVC), PVC-CI (CI between the previous sinus beat and VPC), and left ventricular (LV) stiffness assessed by diastolic wall strain (DWS). DWS was calculated from the M-mode echocardiographic measurement of the LV posterior wall thickness at end-systole (PWs) and end-diastole (PWd) during sinus rhythm, and DWS was defined as (PWs − PWd)/PWs. Results 31patients (28%) had PVC-related symptoms (18 palpitation and 13 pulse deficit). Patients with PVC-related symptoms showed shorter PVC coupling interval index (52±10 vs. 58±11%, p=0.0140), reduced PVC-SV (21±12 vs. 29±17ml, p=0.0103) and decreased DWS (0.38±0.06 vs. 0.42±0.06, p=0.0011). Meanwhile, the level of BNP and ANP, f-QRS, RMS40, QRS morphology of PVC and the total number of PVC per day were not associated with PVC-related symptoms. On multivariate analysis, decreased DWS was only independently associated with PVC-related symptoms (p=0.0357, OR 2.3629 for each 0.1 decrease in DWS 95% CI 1.0583–5.5815). Conclusion The reduced diastolic wall strain relates with PVC-related symptoms. The increased left ventricular stiffness might cause symptoms in patients with PVC. Funding Acknowledgement Type of funding source: None

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