Post-Extrasystolic Potentiation as a Predictor of Recovery of Left Ventricular Dysfunction After Radiofrequency Catheter Ablation

摘要

© 2017Objectives This study hypothesizes that post-extrasystolic potentiation reflects left ventricle contractile reserve and therefore may predict an improvement of premature ventricular contraction (PVC)-induced cardiomyopathy after PVC ablation. Background Post-extrasystolic potentiation is a physiologic phenomenon of blood pressure accentuation after a PVC beat. Methods We performed a retrospective study of patients with a PVC burden of ≥10% PVC/24 h and left ventricular ejection fraction (LVEF) of 50%) to 11.5 in reversible patients to 5 in irreversible patients. In multivariate analysis, the independent predictors of reversible LV function were post-PVC SBP rise (odds ratio [OR]: 4.61; 95% confidence interval [CI]: 1.45 to 15.83 per 5-mm Hg increase; p < 0.001), post-PVC pulse pressure change (OR: 5.2; 95% CI: 2.3 to 18.6 per 5-mm Hg increase; p < 0.001), and PVC QRS duration (OR: 2.78; 95% CI: 1.63 to 10.94 per 10-ms increase; p < 0.001). Conclusions In patients with LV dysfunction and frequent PVC, post-PVC SBP accentuation may be a marker for subsequent recovery of LVEF after ablation in presumed PVC-induced cardiomyopathy.