Relative efficacy of catheter ablation vs antiarrhythmic drugs in treating premature ventricular contractions: A single-center retrospective study

Li Zhong, Ying Hsiang Lee, Xin Miao Huang, Samuel J Asirvatham, Win Kuang Shen, Paul Andrew Friedman, David O. Hodge, Joshua P. Slusser, Zhi Yuan Song, Douglas L Packer, Yong-Mei Cha

Research output: Contribution to journalArticle

75 Citations (Scopus)

Abstract

Background It is unknown whether radiofrequency ablation (RFA) or antiarrhythmic therapy is superior when treating patients with symptomatic premature ventricular contractions (PVCs). Objective To determine the relative efficacy of RFA and antiarrhythmic drugs (AADs) on PVC burden reduction and increasing left ventricular systolic function. Methods Patients with frequent PVCs (>1000/24 h) were treated either by RFA or with AADs from January 2005 through December 2010. Data from 24-hour Holter monitoring and echocardiography before and 6-12 months after treatment were compared between the 2 groups. Results Of 510 patients identified, 215 (40%) underwent RFA and 295 (60%) received AADs. The reduction in PVC frequency was greater by RFA than with AADs (-21,799/24 h vs -8,376/24 h; P <.001). The left ventricular ejection fraction (LVEF) was increased significantly after RFA (53%-56%; P <.001) but not after AAD (52%- 52%; P =.6) therapy. Of 121 (24%) patients with reduced LVEF, 39 (32%) had LVEF normalization to 50% or greater. LVEF was restored in 25 of 53 (47%) patients in the RFA group compared with 14 of 68 (21%) patients in the AAD group (P =.003). PVC coupling interval less than 450 ms, less impaired left ventricular function, and RFA were independent predictors of LVEF normalization performed by using multivariate analysis. Conclusion RFA appears to be more effective than AADs in PVC reduction and LVEF normalization.

Original languageEnglish (US)
Pages (from-to)187-193
Number of pages7
JournalHeart Rhythm
Volume11
Issue number2
DOIs
StatePublished - Feb 2014

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Ventricular Premature Complexes
Catheter Ablation
Anti-Arrhythmia Agents
Stroke Volume
Retrospective Studies
Left Ventricular Function
Ambulatory Electrocardiography
Echocardiography
Therapeutics
Multivariate Analysis

Keywords

  • Antiarrhythmic drug
  • Left ventricular dysfunction
  • Premature ventricular contraction
  • Premature ventricular contraction-induced cardiomyopathy
  • Radiofrequency catheter ablation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Relative efficacy of catheter ablation vs antiarrhythmic drugs in treating premature ventricular contractions : A single-center retrospective study. / Zhong, Li; Lee, Ying Hsiang; Huang, Xin Miao; Asirvatham, Samuel J; Shen, Win Kuang; Friedman, Paul Andrew; Hodge, David O.; Slusser, Joshua P.; Song, Zhi Yuan; Packer, Douglas L; Cha, Yong-Mei.

In: Heart Rhythm, Vol. 11, No. 2, 02.2014, p. 187-193.

Research output: Contribution to journalArticle

Zhong, Li ; Lee, Ying Hsiang ; Huang, Xin Miao ; Asirvatham, Samuel J ; Shen, Win Kuang ; Friedman, Paul Andrew ; Hodge, David O. ; Slusser, Joshua P. ; Song, Zhi Yuan ; Packer, Douglas L ; Cha, Yong-Mei. / Relative efficacy of catheter ablation vs antiarrhythmic drugs in treating premature ventricular contractions : A single-center retrospective study. In: Heart Rhythm. 2014 ; Vol. 11, No. 2. pp. 187-193.
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abstract = "Background It is unknown whether radiofrequency ablation (RFA) or antiarrhythmic therapy is superior when treating patients with symptomatic premature ventricular contractions (PVCs). Objective To determine the relative efficacy of RFA and antiarrhythmic drugs (AADs) on PVC burden reduction and increasing left ventricular systolic function. Methods Patients with frequent PVCs (>1000/24 h) were treated either by RFA or with AADs from January 2005 through December 2010. Data from 24-hour Holter monitoring and echocardiography before and 6-12 months after treatment were compared between the 2 groups. Results Of 510 patients identified, 215 (40{\%}) underwent RFA and 295 (60{\%}) received AADs. The reduction in PVC frequency was greater by RFA than with AADs (-21,799/24 h vs -8,376/24 h; P <.001). The left ventricular ejection fraction (LVEF) was increased significantly after RFA (53{\%}-56{\%}; P <.001) but not after AAD (52{\%}- 52{\%}; P =.6) therapy. Of 121 (24{\%}) patients with reduced LVEF, 39 (32{\%}) had LVEF normalization to 50{\%} or greater. LVEF was restored in 25 of 53 (47{\%}) patients in the RFA group compared with 14 of 68 (21{\%}) patients in the AAD group (P =.003). PVC coupling interval less than 450 ms, less impaired left ventricular function, and RFA were independent predictors of LVEF normalization performed by using multivariate analysis. Conclusion RFA appears to be more effective than AADs in PVC reduction and LVEF normalization.",
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T1 - Relative efficacy of catheter ablation vs antiarrhythmic drugs in treating premature ventricular contractions

T2 - A single-center retrospective study

AU - Zhong, Li

AU - Lee, Ying Hsiang

AU - Huang, Xin Miao

AU - Asirvatham, Samuel J

AU - Shen, Win Kuang

AU - Friedman, Paul Andrew

AU - Hodge, David O.

AU - Slusser, Joshua P.

AU - Song, Zhi Yuan

AU - Packer, Douglas L

AU - Cha, Yong-Mei

PY - 2014/2

Y1 - 2014/2

N2 - Background It is unknown whether radiofrequency ablation (RFA) or antiarrhythmic therapy is superior when treating patients with symptomatic premature ventricular contractions (PVCs). Objective To determine the relative efficacy of RFA and antiarrhythmic drugs (AADs) on PVC burden reduction and increasing left ventricular systolic function. Methods Patients with frequent PVCs (>1000/24 h) were treated either by RFA or with AADs from January 2005 through December 2010. Data from 24-hour Holter monitoring and echocardiography before and 6-12 months after treatment were compared between the 2 groups. Results Of 510 patients identified, 215 (40%) underwent RFA and 295 (60%) received AADs. The reduction in PVC frequency was greater by RFA than with AADs (-21,799/24 h vs -8,376/24 h; P <.001). The left ventricular ejection fraction (LVEF) was increased significantly after RFA (53%-56%; P <.001) but not after AAD (52%- 52%; P =.6) therapy. Of 121 (24%) patients with reduced LVEF, 39 (32%) had LVEF normalization to 50% or greater. LVEF was restored in 25 of 53 (47%) patients in the RFA group compared with 14 of 68 (21%) patients in the AAD group (P =.003). PVC coupling interval less than 450 ms, less impaired left ventricular function, and RFA were independent predictors of LVEF normalization performed by using multivariate analysis. Conclusion RFA appears to be more effective than AADs in PVC reduction and LVEF normalization.

AB - Background It is unknown whether radiofrequency ablation (RFA) or antiarrhythmic therapy is superior when treating patients with symptomatic premature ventricular contractions (PVCs). Objective To determine the relative efficacy of RFA and antiarrhythmic drugs (AADs) on PVC burden reduction and increasing left ventricular systolic function. Methods Patients with frequent PVCs (>1000/24 h) were treated either by RFA or with AADs from January 2005 through December 2010. Data from 24-hour Holter monitoring and echocardiography before and 6-12 months after treatment were compared between the 2 groups. Results Of 510 patients identified, 215 (40%) underwent RFA and 295 (60%) received AADs. The reduction in PVC frequency was greater by RFA than with AADs (-21,799/24 h vs -8,376/24 h; P <.001). The left ventricular ejection fraction (LVEF) was increased significantly after RFA (53%-56%; P <.001) but not after AAD (52%- 52%; P =.6) therapy. Of 121 (24%) patients with reduced LVEF, 39 (32%) had LVEF normalization to 50% or greater. LVEF was restored in 25 of 53 (47%) patients in the RFA group compared with 14 of 68 (21%) patients in the AAD group (P =.003). PVC coupling interval less than 450 ms, less impaired left ventricular function, and RFA were independent predictors of LVEF normalization performed by using multivariate analysis. Conclusion RFA appears to be more effective than AADs in PVC reduction and LVEF normalization.

KW - Antiarrhythmic drug

KW - Left ventricular dysfunction

KW - Premature ventricular contraction

KW - Premature ventricular contraction-induced cardiomyopathy

KW - Radiofrequency catheter ablation

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