The role of interpolation in PVC-induced cardiomyopathy

• Published in: Heart rhythm Vol. 8; no. 7; pp. 1046 - 1049
• Main Authors: Olgun, Hilal, Yokokawa, Miki, Baman, Timir, Kim, Hyungjin Myra, Armstrong, William, Good, Eric, Chugh, Aman, Pelosi, Frank, Crawford, Thomas, Oral, Hakan, Morady, Fred, Bogun, Frank
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.07.2011
• Subjects: Ablation; Cardiomyopathies - etiology; Cardiomyopathies - physiopathology; Cardiomyopathy; Cardiovascular; Catheter Ablation; Disease Progression; Electrocardiography, Ambulatory; Female; Follow-Up Studies; Heart Conduction System - physiopathology; Humans; Interpolation; Male; Middle Aged; Premature ventricular complexes; Retrospective Studies; Ventricular Function, Left; Ventricular Premature Complexes - complications; Ventricular Premature Complexes - physiopathology; Ventricular Premature Complexes - surgery; Interpolation; EF; OR; Cardiomyopathy; Premature ventricular complexes; LV; VA; PVC; Ablation; ejection fraction; ventriculoatrial; odds ratio; left ventricular; premature ventricular complex
• ISSN: 1547-5271; 1556-3871; 1556-3871
• DOI: 10.1016/j.hrthm.2011.02.034

Frequent premature ventricular complexes (PVCs) can cause cardiomyopathy. The mechanism is not known and may be multifactorial. This study assessed the role of PVC interpolation in PVC-induced cardiomyopathy. In 51 consecutive patients (14 women, age 49 ± 15 years, ejection fraction (EF) 0.49 ± 0.14) with frequent PVCs, 24-hour Holter recordings were performed. The amount of interpolation was determined and correlated with the presence of PVC-induced cardiomyopathy. In addition, parameters measured during an electrophysiology study were correlated with the Holter findings. Fourteen of the 21 patients (67%) with cardiomyopathy had interpolated PVCs, compared with only 6 of 30 patients (20%) without PVC-induced cardiomyopathy ( P <.001). Patients with interpolated PVCs had a higher PVC burden than patients without interpolation (28% ± 12% vs. 15% ± 15%; P = .002). The burden of interpolated PVCs correlated with the presence of PVC cardiomyopathy (21% ± 30% vs. 4% ± 13%; P = .008). Both PVC burden and interpolation independently predicted PVC-induced cardiomyopathy (odds ratio 1.07, 95% confidence interval 1.01 to 1.13, P = .02; and odds ratio 4.43, 95% confidence interval 1.06 to 18.48, P = .04, respectively). The presence of ventriculoatrial block at a ventricular pacing cycle length of 600 ms correlated with the presence of interpolation ( P = .004). Patients with interpolation had a longer mean ventriculoatrial block cycle length than patients without interpolated PVCs (520 ± 110 ms vs. 394 ± 92 ms; P = .01). The presence of interpolated PVCs was predictive of the presence of PVC cardiomyopathy. Interpolation may play an important role in the generation of PVC-induced cardiomyopathy.