Effects of radiofrequency catheter ablation for premature ventricular complexes originating from the right ventricular outflow tract on right ventricular function

J Cardiovasc Electrophysiol. 2023 Jan;34(1):189-196. doi: 10.1111/jce.15741. Epub 2022 Nov 15.

Abstract

Introduction: This study aimed to elucidate the relationship between premature ventricular complexes (PVCs) and right ventricular (RV) dysfunction, and the effects of radiofrequency catheter ablation (RFCA) on RV function.

Methods: A total of 110 patients (age, 50.8 ± 14.4 years; 30 men) without structural heart disease who had undergone RFCA for RV outflow tract (RVOT) PVCs were retrospectively included. RV function was assessed using fractional area change (FAC) and global longitudinal strain (GLS) before and after RFCA. Clinical data were compared between the RV dysfunction (n = 63) and preserved RV function (n = 47) groups. The relationship between PVC burden and RV function was analyzed. Change in RV function before and after RFCA was compared between patients with successful and failed RFCA.

Results: PVC burden was significantly higher in the RV dysfunction group than in the preserved RV function group (p < .001). FAC and GLS were significantly worse in proportion to PVC burden (p < .001 and p < .001, respectively). The risk factor associated with RV dysfunction was PVC burden [odds ratio (95% confidence interval), 1.092 (1.052-1.134); p < .001]. Improvement in FAC (13.0 ± 8.7% and -2.5 ± 5.6%, respectively; p < .001) and GLS (-6.8 ± 5.7% and 2.1 ± 4.2%, respectively; p < .001) was significant in the patients with successful RFCA, compared to the patients in whom RFCA failed.

Conclusions: Frequent RVOT PVCs are associated with RV dysfunction. RV dysfunction is reversible by successful RFCA.

Keywords: dysfunction; premature ventricular complex; radiofrequency catheter ablation; right ventricle; right ventricular outflow tract.

MeSH terms

  • Adult
  • Aged
  • Catheter Ablation* / adverse effects
  • Heart Ventricles / diagnostic imaging
  • Heart Ventricles / surgery
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • Treatment Outcome
  • Ventricular Dysfunction, Right* / diagnostic imaging
  • Ventricular Dysfunction, Right* / etiology
  • Ventricular Dysfunction, Right* / surgery
  • Ventricular Function, Right
  • Ventricular Premature Complexes* / complications
  • Ventricular Premature Complexes* / diagnosis
  • Ventricular Premature Complexes* / surgery