Risk Factors for the Development of Premature Ventricular Complex-induced Cardiomyopathy: a Systematic Review and Meta-analysis

Overview

Journal J Interv Card Electrophysiol

Publisher Springer

Date 2022 Nov 22

PMID 36414810

Authors

Jeanne du Fay de Lavallaz

Julien Mezier

Lara Mertz

Diego Mannhart

Teodor Serban

Sven Knecht

Qurrat-Ul-Ain Abid

Tai Tri Nguyen

Michael Kuhne

Christian Sticherling

Henry Huang

Michael R Gold

Patrick Badertscher

Affiliations

Soon will be listed here.

Abstract

Background: Premature ventricular complexes (PVCs) are a potentially reversible cause of heart failure. However, the characteristics of patients most likely to develop impaired left ventricular function are unclear. Hence, the objective of this study is to systematically assess risk factors for the development of PVC-induced cardiomyopathy.

Methods: We performed a structured database search of the scientific literature for studies investigating risk factors for the development of PVC-induced cardiomyopathy (PVC-CM). We investigated the reporting of PVC-CM risk factors (RF) and assessed the comparative association of the different RF using random-effect meta-analysis.

Results: A total of 26 studies (9 prospective and 17 retrospective studies) involving 16,764,641 patients were analyzed (mean age 55 years, 58% women, mean PVC burden 17%). Eleven RF were suitable for quantitative analysis (≥ 3 occurrences in multivariable model assessing a binary change in left ventricular (LV) function). Among these, age (OR 1.02 per increase in the year of age, 95% CI [1.01, 1.02]), the presence of symptoms (OR 0.18, 95% CI [0.05, 0.64]), non-sustained ventricular tachycardias (VT) (OR 3.01, 95% CI [1.39, 6.50]), LV origin (OR 2.20, 95% CI [1.14, 4.23]), epicardial origin (OR 4.72, 95% CI [1.81, 12.34]), the presence of interpolation (OR 4.93, 95% CI [1.66, 14.69]), PVC duration (OR 1.05 per ms increase in QRS-PVC duration [1.004; 1.096]), and PVC burden (OR 1.06, 95% CI [1.04, 1.08]) were all significantly associated with PVC-CM.

Conclusions: In this meta-analysis, the most consistent risk factors for PVC-CM were age, non-sustained VT, LV, epicardial origin, interpolation, and PVC burden, whereas the presence of symptoms significantly reduced the risk. These findings help tailor stringent follow-up of patients presenting with frequent PVCs and normal LV function.

Citing Articles

Definition and management of arrhythmia-induced cardiomyopathy: findings from the European Heart Rhythm Association survey.

Serban T, Badertscher P, du Fay de Lavallaz J, Providencia R, Migliore F, Mugnai G Europace. 2024; 26(5).

PMID: 38693772 PMC: 11094751. DOI: 10.1093/europace/euae112.

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