Skip to main content
SpringerLink
Log in

Improvement of left ventricular diastolic function and left atrial reverse remodeling after catheter ablation of premature ventricular complexes

  • Published:
Journal of Interventional Cardiac Electrophysiology Aims and scope Submit manuscript

Abstract

Aims

Catheter ablation of premature ventricular complexes (PVC) improves left ventricular (LV) systolic performance in certain patients; however, the effect on diastolic function and left atrial (LA) remodeling is unclear. We assessed the effects of catheter ablation of PVCs on parameters of LV diastolic function and LA remodeling.

Methods

Forty-seven patients (age 65 ± 10 years, 46 men) who underwent catheter ablation for symptomatic PVCs were evaluated using two-dimensional echocardiography before and 6 ± 2 months after ablation. The measured diastolic indices included mitral inflow parameters (E wave, A wave, E/A ratio, and deceleration time (DT)), mitral lateral annulus early diastolic velocity (Ea), and E/Ea ratio. The LA volume was measured using modified biplane Simpson's method. We also compared the changes in the left atrial volumes and left atrial volume index (LAVI) after PVC ablation.

Results

After catheter ablation of PVCs, the mean LV ejection fraction (EF) increased significantly (49.9 ± 10.3 vs. 42.8 ± 11.8, p < 0.01). Significant improvement was also seen in A wave velocity (71.3 ± 17.1 vs. 59.5 ± 15.1 cm/s, p = 0.039), E/A ratio (1.42 ± 0.6 vs. 1.07 ± 0.5 ml, p = 0.034), Ea (8.9 ± 3.9 vs. 6.8 ± 2.9 cm/s, p = 0.04), and E/Ea ratio (15.4 ± 5.8 vs. 10.6 ± 3.4, p = 0.027), whereas mitral E and DT did not show significant change. LAVI decreased significantly after ablation (44.4 ± 14.8 vs. 36.7 ± 12.5, p < 0.001). Significant improvement in LAVI was also seen in patients with normal baseline LVEF (p = 0.04).

Conclusion

Catheter ablation of PVCs improved LV diastolic function and resulted in left atrial reverse remodeling.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Huizar, J. F., Kaszala, K., Potfay, J., Minisi, A. J., Lesnefsky, E. J., Abbate, A., Mezzaroma, E., Chen, Q., Kukreja, R. C., Hoke, N. N., Thacker, L. R., 2nd, Ellenbogen, K. A., & Wood, M. A. (2011). Left ventricular systolic dysfunction induced by ventricular ectopy: a novel model for premature ventricular contraction-induced cardiomyopathy. Circulation. Arrhythmia and Electrophysiology, 4, 543–549.

    Article  PubMed  Google Scholar 

  2. Shanmugam, N., Chua, T. P., & Ward, D. (2006). 'Frequent' ventricular bigeminy–a reversible cause of dilated cardiomyopathy. How frequent is 'frequent'? European Journal of Heart Failure, 8, 869–873.

    Article  PubMed  CAS  Google Scholar 

  3. Yokokawa, M., Kim, H. M., Good, E., Crawford, T., Chugh, A., Pelosi, F., Jr., Jongnarangsin, K., Latchamsetty, R., Armstrong, W., Alguire, C., Oral, H., Morady, F., & Bogun, F. (2012). Impact of QRS duration of frequent premature ventricular complexes on the development of cardiomyopathy. Heart Rhythm, 9, 1460–1464.

    Article  PubMed  Google Scholar 

  4. Lakkireddy, D., Di Biase, L., Ryschon, K., Biria, M., Swarup, V., Reddy, Y. M., Verma, A., Bommana, S., Burkhardt, D., Dendi, R., Dello Russo, A., Casella, M., Carbucicchio, C., Tondo, C., Dawn, B., & Natale, A. (2012). Radiofrequency ablation of premature ventricular ectopy improves the efficacy of cardiac resynchronization therapy in nonresponders. Journal of the American College of Cardiology, 60, 1531–1539.

    Article  PubMed  Google Scholar 

  5. Deyell, M. W., Park, K. M., Han, Y., Frankel, D. S., Dixit, S., Cooper, J. M., Hutchinson, M. D., Lin, D., Garcia, F., Bala, R., Riley, M. P., Gerstenfeld, E., Callans, D. J., & Marchlinski, F. E. (2012). Predictors of recovery of left ventricular dysfunction after ablation of frequent ventricular premature depolarizations. Heart Rhythm, 9, 1465–1472.

    Article  PubMed  Google Scholar 

  6. Kim, Y. H., Park, S. M., Lim, H. E., Pak, H. N., Kim, Y. H., & Shim, W. J. (2010). Chronic frequent premature ventricular complexes originating from right and non-right ventricular outflow tracts. International Heart Journal, 51, 388–393.

    Article  PubMed  Google Scholar 

  7. Quinones, M. A., Otto, C. M., Stoddard, M., Waggoner, A., & Zoghbi, W. A. (2002). Recommendations for quantification of Doppler echocardiography: a report from the Doppler quantification task force of the nomenclature and standards committee of the american society of echocardiography. Journal of the American Society of Echocardiography, 15, 167–184.

    Article  PubMed  Google Scholar 

  8. Lang, R. M., Bierig, M., Devereux, R. B., Flachskampf, F. A., Foster, E., Pellikka, P. A., Picard, M. H., Roman, M. J., Seward, J., Shanewise, J. S., Solomon, S. D., Spencer, K. T., Sutton, M. S., & Stewart, W. J. (2005). Recommendations for chamber quantification: a report from the american society of echocardiography's guidelines and standards committee and the chamber quantification writing group, developed in conjunction with the european association of echocardiography, a branch of the European Society of Cardiology. Journal of the American Society of Echocardiography, 18, 1440–1463.

    Article  PubMed  Google Scholar 

  9. Wijnmaalen, A. P., Delgado, V., Schalij, M. J., van Huls van Taxis, C. F., Holman, E. R., Bax, J. J., & Zeppenfeld, K. (2010). Beneficial effects of catheter ablation on left ventricular and right ventricular function in patients with frequent premature ventricular contractions and preserved ejection fraction. Heart, 96, 1275–1280.

    Article  PubMed  Google Scholar 

  10. Bogun, F., Crawford, T., Reich, S., Koelling, T. M., Armstrong, W., Good, E., Jongnarangsin, K., Marine, J. E., Chugh, A., Pelosi, F., Oral, H., & Morady, F. (2007). Radiofrequency ablation of frequent, idiopathic premature ventricular complexes: comparison with a control group without intervention. Heart Rhythm, 4, 863–867.

    Article  PubMed  Google Scholar 

  11. Lu, F., Benditt, D. G., Yu, J., & Graf, B. (2012). Effects of catheter ablation of "asymptomatic" frequent ventricular premature complexes in patients with reduced (<48%) left ventricular ejection fraction. The American Journal of Cardiology, 110, 852–856.

    Article  PubMed  Google Scholar 

  12. Lau, C. P., Yu, C. M., Chau, E., Fan, K., Tse, H. F., Lee, K., Tang, M. O., Wan, S. H., Law, T. C., Lee, P. Y., Lam, Y. M., & Hill, M. R. (2000). Reversal of left ventricular remodeling by synchronous biventricular pacing in heart failure. Pacing and Clinical Electrophysiology, 23, 1722–1725.

    Article  PubMed  CAS  Google Scholar 

  13. Adabag, S., Smith, L. G., Anand, I. S., Berger, A. K., & Luepker, R. V. (2012). Sudden cardiac death in heart failure patients with preserved ejection fraction. Journal of Cardiac Failure, 18, 749–754.

    Article  PubMed  Google Scholar 

  14. Eichhorn, E. J., Willard, J. E., Alvarez, L., Kim, A. S., Glamann, D. B., Risser, R. C., & Grayburn, P. A. (1992). Are contraction and relaxation coupled in patients with and without congestive heart failure? Circulation, 85, 2132–2139.

    Article  PubMed  CAS  Google Scholar 

  15. Wang, J., Kurrelmeyer, K. M., Torre-Amione, G., & Nagueh, S. F. (2007). Systolic and diastolic dyssynchrony in patients with diastolic heart failure and the effect of medical therapy. Journal of the American College of Cardiology, 49, 88–96.

    Article  PubMed  Google Scholar 

  16. Rienstra, M., & Van Gelder, I. C. (2006). Left atrial volume predicts cardiovascular events in patients originally diagnosed with lone atrial fibrillation: three-decade follow-up. European Heart Journal, 27, 756. author reply 756.

    Article  PubMed  Google Scholar 

  17. Tsang, T. S., Barnes, M. E., Abhayaratna, W. P., Cha, S. S., Gersh, B. J., Langins, A. P., Green, T. D., Bailey, K. R., Miyasaka, Y., & Seward, J. B. (2006). Effects of quinapril on left atrial structural remodeling and arterial stiffness. The American Journal of Cardiology, 97, 916–920.

    Article  PubMed  CAS  Google Scholar 

  18. Reant, P., Lafitte, S., Jais, P., Serri, K., Weerasooriya, R., Hocini, M., Pillois, X., Clementy, J., Haissaguerre, M., & Roudaut, R. (2005). Reverse remodeling of the left cardiac chambers after catheter ablation after 1 year in a series of patients with isolated atrial fibrillation. Circulation, 112, 2896–2903.

    PubMed  Google Scholar 

  19. Casaclang-Verzosa, G., Gersh, B. J., & Tsang, T. S. (2008). Structural and functional remodeling of the left atrium: clinical and therapeutic implications for atrial fibrillation. Journal of the American College of Cardiology, 51, 1–11.

    Article  PubMed  Google Scholar 

  20. Oki, T., Tabata, T., Yamada, H., Wakatsuki, T., Shinohara, H., Nishikado, A., Iuchi, A., Fukuda, N., & Ito, S. (1997). Clinical application of pulsed Doppler tissue imaging for assessing abnormal left ventricular relaxation. The American Journal of Cardiology, 79, 921–928.

    Article  PubMed  CAS  Google Scholar 

  21. Myreng, Y., Smiseth, O. A., & Risoe, C. (1990). Left ventricular filling at elevated diastolic pressures: relationship between transmitral Doppler flow velocities and atrial contribution. American Heart Journal, 119, 620–626.

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgments

We are grateful to Anne Steckler and Deb Johnson, registered nurses, for the efforts in administering this research project.

Conflict of interest

None.

Author information

Authors and Affiliations

  1. Cardiovascular Division, University of Minnesota Medical School, Minneapolis, MN, USA

    Mehmet Akkaya, Henri Roukoz & David G. Benditt

  2. Division of Cardiology, Veterans Administration Medical Center, One Veterans Drive, Minneapolis, MN, 55417, USA

    Selcuk Adabag, Inder Anand, Jian Ming Li, Marina Zakharova & Venkat Tholakanahalli

Authors
  1. Mehmet Akkaya
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Henri Roukoz
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Selcuk Adabag
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. David G. Benditt
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Inder Anand
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Jian Ming Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Marina Zakharova
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Venkat Tholakanahalli
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Venkat Tholakanahalli.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Akkaya, M., Roukoz, H., Adabag, S. et al. Improvement of left ventricular diastolic function and left atrial reverse remodeling after catheter ablation of premature ventricular complexes. J Interv Card Electrophysiol 38, 179–185 (2013). https://doi.org/10.1007/s10840-013-9836-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10840-013-9836-0

Keywords

Search

Navigation