Radiofrequency Catheter Ablation of Premature Ventricular Beats among Egyptians: Predictors of Success and Recurrence

Abdelmonaem, Mustafa Mohamed; Galal, Wagdy Abdelhamid; Eldamenhoury, Hayam Mohamed; Abdelhamid, Mohamed Amin; Ahmed, Rania Samir; Badran, Haitham Abd El Fattah

doi:10.12816/0021413

Radiofrequency Catheter Ablation of Premature Ventricular Beats among Egyptians: Predictors of Success and Recurrence

Document Type : Original Article

Authors

Department of Cardiology, Faculty of Medicine, Ain Shams University, Cairo, Egypt

10.12816/0021413

Abstract

Background: Premature ventricular beats (PVBs) are early depolarization of the myocardium originating in the ventricle, the prognosis in patients with frequent PVBs and no obvious organic heart disease is usually very good. However, many patients are severely symptomatic with impaired quality of life.
Aim of the study: We aimed at our study to assess the success of radiofrequency catheter ablation of monomorphic PVB and its impact on improvement of left ventricular (LV) systolic functions.
Patients and Methods: The current study was conducted on 40 patients with frequent symptomatic monomorphic PVBs, candidate for PVB radiofrequency catheter ablation in cardiology department, Ain Shams University, between 2013 and 2015. All patients were subjected to thorough history taking, complete general and local examination, conventional 2D echocardiography and pre-procedural Holter ECG monitoring. Patients were divided to two groups (20 patients in each group) according to the presence or absence of structural heart disease. Electrophysiological mapping and ablation was done for all patients, and their clinical, electrophysiological and procedural aspects were analyzed. Follow up echocardiography and Holter ECG monitoring was done 3-6 months later to assess recurrence and impact on LV internal dimensions and systolic functions.
Results: Acute success was achieved in 35 patients (87.5%), and long term success was achieved in 30 patients (75%), with elimination of PVBs and distressing symptoms among group of patients with procedural success. Presence of structural heart disease was not related statistically to procedural failure or long term recurrence. Magnitude of reduction of PVB burden had significant correlation with improvement of systolic functions (P=0.04). Significant improvement of echocardiographic parameters was witnessed among group with baseline LV systolic dysfunction.
Conclusions: Radiofrequency catheter ablation is an effective and safe therapeutic tool for frequent monomorphic PVBs and should be addressed as 1^st line option for reversal of PVB induced LV systolic dysfunction.

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