Premature ventricular contractions and quality of life: a state-of-the-art review and psychological perspective
M Macgillivray, S Gallagher, E M Rogers, I Caramlau, R Bourke, E Babatunde, R SheahanAbstract
Background
Premature Ventricular Contractions (PVCs) can impair quality of life (QOL). Symptoms can vary over time. Patients even with a low burden of PVCs report effects on quality of life. This systematic review focuses on the psychological factors and their contribution to symptom perception.
Methods
This systematic review was conducted in accordance with PRISMA-ScR guidelines involving search of databases including MEDLINE, CINAHL, PsycARTICLES, Web of Science, and PubMed for studies that accessed QOL in adults (>18 years) as a primary/secondary outcome with structurally normal hearts (>95%) and limited comorbidities (<25%).
Results
Six Studies, including 408 patients, were included. The patients were predominantly Female (53.2%), age range 30-52.7 years, with structural heart disease excluded by echocardiography. PVC burden was reported as a percentage (7.9 to 18.5%) or count (2,583 to 34,321) per day. Treatment included Beta-Blockers (49.6%), Calcium Channel Blockers (27.7%), Antiarrhythmic agents (41.2%; with equal distribution between Class 1 and Class 3 agents). A PVC Focal Ablation was performed in 45.8%. Post treatment, there were decreases in psychological factors including depression, anxiety, cardiac anxiety, fear towards bodily symptoms and stress. In patients post ablation, there was a decrease in mood and anxiety, and mental health. Post both medications or ablation, there was an improvement of lifestyle factors such as physical activity, avoidance of cardiac-related activities, and social functioning.
Conclusion
This systematic review highlights the importance of psychological and lifestyle factors in providing a patient centred approach to the care of patients with symptomatic PVCs. Future studies should explore the role of targeted interventions in the management of these symptoms.