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

[ Vol. 16 , Issue. 4 ]

Author(s):

Farbod Z. Tajrishi, Mohammad H. Asgardoon, Amirhossein S. Hosseinpour, Alipasha Meysamie and Ali Vasheghani-Farahani*   Pages 315 - 325 ( 11 )

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.

Affiliation:

School of Medicine, Babol University of Medical Sciences, Babol, Iranian Student Society for Immunodeficiencies, Students’ Scientific Research Center, Tehran University of Medical Sciences, Tehran, School of Medicine, Tehran University of Medical Sciences, Tehran, Community and Preventive Medicine Department, Tehran University of Medical Sciences, Tehran, Cardiac Primary Prevention Research Center (CPPRC), Tehran Heart Center, Tehran University of Medical Sciences Tehran

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