Premature ventricular contraction-induced cardiomyopathy

Authors: B.Sh. Berdibekov, S.A. Aleksandrova, D.V. Mrikaev, E.Z. Golukhova

Company: Bakoulev National Medical Research Center for Cardiovascular Surgery, Moscow, 121552, Russian Federation

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Type:  Reviews


DOI: https://doi.org/10.24022/1997-3187-2020-14-2-125-137

For citation: Berdibekov B.Sh., Aleksandrova S.A., Mrikaev D.V., Golukhova E.Z. Premature ventricular contraction- induced cardiomyopathy. Creative Cardiology. 2020; 14 (2): 125–37 (in Russ.). DOI: 10.24022/1997-3187-2020-14- 2-125-137

Received / Accepted:  10.06.2020 / 15.06.2020

Keywords: рremature ventricular contractions сardiomyopathy

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Abstract

Premature ventricular contractions (PVCs) are the most common type of ventricular arrhythmias. PVCs are common with an estimated prevalence of 40 to 75% in the general population on 24 to 48 hour Holter monitoring. Traditionally, they have been thought to be relatively benign in the absence of structural heart disease. Over the last decade, however, PVC-induced cardiomyopathy (CMP) has been a subject of great interest and the evidence for this entity is rapidly emerging. PVC-associated cardiomyopathy is associated with a high burden of PVC (over 20% of heartbeats). Other risk factors include electrophysiological characteristics, such as PVC QRS width, presence of ventricular tachycardia, interpolation and polymorphic PVCs, and longer coupling intervals. Symptoms include palpitations, lightheadedness, dyspnea, cough, and dysphagia. The systolic dysfunction and chamber dilatation progress over a few years. Once the PVCs are suppressed by radiofrequency ablation or antiarrhythmic drugs, the cardiomyopathy usually resolves within 6 months. The pathophysiology remains unknown, but hypotheses mainly include ventricular dyssynchrony resulting in hemodynamic disturbances and abnormalities in calcium handling. In this review, the clinical syndrome of PVC-induced cardiomyopathy, including risk factors for development and treatment, is discussed.

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About Authors

Bektur Sh. Berdibekov, Postgraduate, orcid.org/0000-0001-7717-4971
Svetlana A. Aleksandrova, Cand. Med. Sc., Senior Researcher, orcid.org/0000-0002-7795-9709
David V. Mrikaev, Cand. Med. Sc., Researcher, Cardiologist, orcid.org/0000-0003-4237-0758
Elena Z. Golukhova, Dr. Med. Sc., Professor, Academician of RAS, orcid.org/0000-0002-6252-0322

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, Director of Bakoulev National Medical Research Center for Cardiovascular Surgery