Idiopathic premature ventricular contractions: a retrospective longitudinal analysis of the association with ventricular dysfunction and cardiovascular outcomes
C Oliveira Ferreira, E Silva, F Vilela, B Rocha, J Faria, S Fernandes, M Dias, I Conde, C Galvao, C Oliveira, R FloresAbstract
Introduction
Idiopathic premature ventricular contractions (PVC) are common findings in clinical practice. Although often considered benign, high PVC burden has been linked to left ventricular dysfunction and adverse cardiovascular outcomes. The aim of this study was to evaluate the association between PVC burden and left ventricular ejection fraction (LVEF), and to determine the proportion of individuals who developed presumed PVC-induced dysfunction and other cardiovascular outcomes.
Methods
A retrospective observational study was conducted, involving 54 patients with PVC burden ≥10% on 24-hour Holter monitoring. The follow-up was longitudinal, with serial assessments of PVC burden and LVEF by transthoracic echocardiography. Multiple linear regression models adjusted for age and sex were performed to analyze the relationship between PVC burden and LVEF. Logistic regression models were used to assess the presence of cardiovascular outcomes.
Results
The median baseline PVC burden was 22.5% [15.1 – 31.1]. A significant inverse association was observed between PVC burden and LVEF at T3 (B = –0.31; 95% C I –0.60 to –0.03; p = 0.034). P resumed PVC-induced dysfunction occurred in 5.6% (n = 3) of participants. Both mean and maximum PVC burden were independent predictors of referral for ablation (OR 1.11; 95% CI 1.02–1.20; p = 0.013 and OR 1.10; 95% CI 1.02–1.18; p = 0.011, respectively).
Conclusion
A high PVC burden was associated with lower LVEF at mid to long-term follow-up, suggesting a cumulative effect on cardiac function. Mean and maximum PVC burden were independent predictors of referral for ablation. These findings underscore the importance of systematic longitudinal follow-up and the need for prospective studies to refine risk stratification and optimize therapeutic strategies in this population.