Reversal of dilated cardiomyopathy by the elimination of frequent left or right premature ventricular contractions

Abstract

RF ablation of frequent premature ventricular contractions (PVC) has recently been shown to improve left ventricular (LV) systolic function and dimensions in a few patients, however mainly when they originated from the right ventricular outflow tract. RF ablation was performed at various ventricular locations in six consecutive patients with frequent, isolated PVC associated with idiopathic dilated cardiomyopathy (DCM). Baseline clinical status, PVC counts, LV ejection fraction (EF) and end-diastolic diameter (EDD) were recorded at baseline and at 6 months of follow-up. PVC ablation was performed in the right ventricle in four patients, the left ventricle in two patients. Before RF ablation, five patients were in New York Heart Association (NYHA) functional class I, and one patient was in class II. After RF ablation, the mean PVC count/24 h decreased from 17,717 ± 7,100 to 268 ± 366 (p = 0.006) while LVEF increased from 42 ± 2.5% to 57 ± 3% (p = 0.0001) and LVEDD decreased from 60.0 ± 3.5 to 54.0 ± 3.7 mm (p = 0.0009). The clinical status normalized with regression of palpitations and NYHA class. Elimination of frequent isolated PVC in patients with DCM with RF can normalize the clinical status and LV systolic function and dimensions, regardless of the morphology or origin of the PVC.