Does the origin of ablated premature ventricular contractions determine the level of left ventricle remodeling

BACKGROUND: Premature ventricular complexes (PVCs) are associated with tachycardiomyopathy (TCM) and high mortality rate. The treatment depends on the engaged chamber. PVC originating from the right outflow is recommended for radiofrequency catheter ablation (RFCA) (class IB-R) in preference to pharmacotherapy, in the left ventricle, ablation is a class IIa B-NR indication. AIMS: The aim of the study was the assessment of the success of the RFCA of premature ventricular contractions based on arrhythmic focus loci. METHODS: 110 consecutive patients with monomorphic PVCs referred for ablation were enrolled, and divided according to the site of ablation to the outflow tract (OT) and the ventricles (VENT). Holter electrocardiography and echocardiography before and 6 months after the procedure was performed. RESULTS: Long term RFCA success was achieved in 93 (85%) patients (89% in the OT and 82% in the VENT; P = 0.39). The median [IQR] PVC reduction (%) was similar in both groups (by 99.55 [14] and 99.88 [6] respectively, P = 0.56). The OT group presented greater left ventricle recovery then the VENT (odds ratio 2.01; 95% confidence interval: 1.15 - 10.75; P = 0.015). The procedure in the VENT group was longer, required additional access, complication rate was similar, 1 serious adverse event (aortic dissection) was connected with the left ventricular outflow. CONCLUSIONS: PVC origin does not determine the success of arrhythmia elimination. The outflow tract origin may predict LV improvement. RFCA in the VENT group was longer. The outflow tract origin may predict reversal of LV deterioration.