Premature ventricular complexes: diagnostic and therapeutic considerations in clinical practice A state-of-the-art review by the American College of Cardiology Electrophysiology Council


GÖRENEK B. , Fisher J. D. , Kudaiberdieva G., Baranchuk A., Burri H., Campbell K. B. , ...More

JOURNAL OF INTERVENTIONAL CARDIAC ELECTROPHYSIOLOGY, vol.57, no.1, pp.5-26, 2020 (Journal Indexed in SCI) identifier identifier identifier

  • Publication Type: Article / Review
  • Volume: 57 Issue: 1
  • Publication Date: 2020
  • Doi Number: 10.1007/s10840-019-00655-3
  • Title of Journal : JOURNAL OF INTERVENTIONAL CARDIAC ELECTROPHYSIOLOGY
  • Page Numbers: pp.5-26
  • Keywords: Premature ventricular complexes, Electrocardiography, Ambulatory monitoring, Imaging, Exercise testing, Electrophysiology study, Catheter ablation, CARDIOVASCULAR MAGNETIC-RESONANCE, RADIOFREQUENCY CATHETER ABLATION, MITRAL-VALVE-PROLAPSE, TERM FOLLOW-UP, OUTFLOW TRACT, HEART-DISEASE, PROGNOSTIC-SIGNIFICANCE, DOUBLE-BLIND, HISTOLOGICAL VALIDATION, INDUCED CARDIOMYOPATHY

Abstract

Premature ventricular complexes (PVCs) are common arrhythmias in the clinical setting. PVCs in the structurally normal heart are usually benign, but in the presence of structural heart disease (SHD), they may indicate increased risk of sudden death. High PVC burden may induce cardiomyopathy and left ventricular (LV) dysfunction or worsen underlying cardiomyopathy. Sometimes PVCs may be a marker of underlying pathophysiologic process such as myocarditis. Identification of PVC burden is important, since cardiomyopathy and LV dysfunction can reverse after catheter ablation or pharmacological suppression. This state-of-the-art review discusses pathophysiology, clinical manifestations, how to differentiate benign and malignant PVCs, PVCs in the structurally normal heart, underlying SHD, diagnostic procedures (physical examination, electrocardiogram, ambulatory monitoring, exercise testing, echocardiography, cardiac magnetic resonance imaging, coronary angiography, electrophysiology study), and treatment (lifestyle modification, electrolyte imbalance, medical, and catheter ablation).