Abstract 19438: Premature Ventricular Contractions and Cardiomyopathy: A Retrospective Cohort Study
Introduction: Premature Ventricular Contractions (PVC) are common with prevalence over 50% according to some studies. In the absence of an underlying cause and symptoms PVCs are considered benign and do not require therapy. Some have argued, however that increasing burden may be a risk factor for developing cardiomyopathy (CM). However, there are no studies looking at PVC burden and relationship to cardiomyopathy and the question remains unanswered.
Hypothesis: Increased frequency of PVCs is associated with a higher risk of CM.
Methods: Using the Olmsted County database, 696 patients were identified. In these patients we studied the overall prevalence of CM as a function of PVC burden. We also evaluated the incidence of CM, change in left ventricular ejection fraction (EF) and change in left ventricular end diastolic dimension (LVEDD) as a function of PVC burden over time. This was done in a 104 patient subset with a holter study an echocardiogram within 100 days of the holter study and a subsequent echocardiogram at least 100 days after the first echocardiogram. Significant EF change was a drop of EF greater than at least 10% and a significant LVEDD increase was a LVEDD increase of at least 1cm.
Results: In all comers, there was a significant difference in the PVC burden of patients with known CM vs those without a CM (7.23% vs 4.39%, p=.0044) regardless of the time between diagnosis of cardiomyopathy and holter study. In patients with serial echocardiograms: There was no difference in mean PVC burden between patients who had a significant EF decrease compared to patients who did not (2.9% vs 6.1%, p=.3695). There was also no difference in the PVC burden between patients who had a significant LVEDD increase vs those without (4.3% vs 7.5%, p=.0892). In patients with >10% PVC burden, there was no difference in the mean change in EF (2.4% vs -.7%, p=.2145) or in mean change in LVEDD (-1.50 cm vs .14 cm, p=.1703) compared to patients w/ less than 10% PVC burden. 1/22 patients with PVC burden >10% had a 10% EF drop compared to 6/82 patients with PVC burden <10% (Pearson Chi square=.212, p=.6450)
Conclusions: PVC burden is not directly related to significant EF or LVEDD changes and thus should not be targeted for treatment if they are otherwise asymptomatic and healthy.
Author Disclosures: K. Manocha: None. S. Sirichand: None. D. Snipelisky: None. S. Mulpuru: None. S. Kapa: Honoraria; Modest; St. Jude.
- © 2016 by American Heart Association, Inc.