Abstract 16777: Premature Ventricular Beats From Left and Right Ventricular Outflow Tract - Distinct Clinical Entities of Similar Ecg Patterns
Introduction: Ventricular tachycardias (VTs) and premature ventricular beats (PVBs) originating from ventricular outflow tracts are considered to be associated with a benign prognosis. By now VTs and PVBs from right (RVOT) and left ventricular outflow tract (LVOT) are assumed to be variants of the same clinical entity. In this study we analyzed demographic and clinical characteristics of patients with RVOT and LVOT arrhythmias.
Methods: From 2008 to 2012, 177 consecutive patients with symptomatic outflow tract VTs/PVBs underwent an EP-study with conventional pace- and activation mapping and RFCA, assessing either the RVOT (n=83) or LVOT (n=94) as arrhythmic origin. Patients were grouped accordingly and analyzed regarding baseline characteristics, prevalence of cardiovascular co-morbidity (hypertension, coronary heart disease, valvular diseases, cardiomyopathy and cerebrovascular diseases), systolic dysfunction, and extra-cardiovascular diseases (diabetes mellitus, renal insufficiency, chronic obstructive pulmonary disease, obstructive sleep apnea).
Results: Patients with PVBs from the LVOT are significantly older than RVOT patients; they show a significantly higher prevalence of arterial hypertension and both cardiovascular and extra-cardiovascular diseases than patients with RVOT origin. The prevalence of disorders in cardiac impulse generation and propagation is significantly higher in LVOT patients too. Details are shown in table 1.
There were no significant differences between the RVOT and LVOT group regarding the average number of PVBs/day (21241.9 vs. 23202.7, p=0.21) and RFCA success rate (88% vs. 82%, p=0.13).
Conclusions: Our study suggests different pathophysiologic mechanisms in RVOT and LVOT VTs/PVBs, pointing towards more severe underlying cardiovascular disease in patients with LVOT PVBs. Thus the clinical consequences may be diverse between RVOT and LVOT PVB patients.
- © 2013 by American Heart Association, Inc.