The Relationship Between Premature Ventricular Contractions Induced Cardiomyopathy And PVCs Coupling Interval

BackgroundFor the past 50 years,premature ventricular contraction(PVCs)has been a controversial and significal topic.A lot of initial research pay attention on the patients who suffering myocardial infarction and their subsequent risk of sustained ventricular arrhythmias.In the 1990s,as the specific treatment of premature ventricular contraction failure to alter outcomes in the postmyocardial infarction population,in addition to early failure in the general congestive heart failure population,the interest of premature ventricular contraction decrease。However,there has been a resurgent interest in frequent PVCs led by the novel concept that they may be a potential cause of.or at least contribute to cardiomyopathy.Although rare in the general population,frequent PVCs are more common among patients with left ventricular(LV)dysfunction and CHF.This growing interest in PVCs was instigated by Duffee and colleagues,who described significant improvement in cardiac function among five patients with frequent PVCs(>20 000/24 h)and LV dysfunction,who had suppression of PVCs with amiodarone.This suggested,for the first time,that frequent PVCs might result in reversible LV dysfunction termed ’PVC-induced cardiomyopathy’.The novel observation of direct consequences of frequent PVCs has potential implications for all patients with CHF and LV dysfunction.Frequent PVCs may contribute to ongoing or deteriorating LV dysfunction even in the presence of an established cause for CHF.Treatment of the PVCs in these instances may result in partial improvement of LV dysfunction.Highlighting the knowledge gaps that surround frequent PVCs is the lack of a standard definition of PVC-induced cardiomyopathy.Previous definitions in the literature of PVC-induced cardiomyopathy include either having an abnormal left ventricular ejection fraction(LVEF)which improved by at least 15%or 10%or normalization of LVEF>50%after an effective ablation procedure.Considerable interest in PVC-induced cardiomyopathy has arisen among electrophysiologists,fueled by the evolution of safer and more efficacious treatments for frequent PVCs,particularly catheter ablation.However,much of the fundamental pathophysiology and epidemiology of PVC-induced cardiomyopathy remains poorly understood.Further hampering our efforts to understand the impact of frequent PVCs is the fact that they are often asymptomatic and patients most commonly present with concomitant frequent PVCs and LV dysfunction.ObjectivesTo determine the role of Radiofrequency catheter ablation in patients with premature ventricular contractions-induced cardiomyopathy and to investigate the relation of coupling interval to PVCs-ICM.MethodsRandom between January 2014 and Octorber 2016,our hospital during the period of receiving frequent 102 monophyletic of ventricular premature beat patients as the research object,in all cases can be treated for RFCA,at the same time relevant inspections on all cases before the operation,including ultrasonic,24 h dynamic ecg examination.Will be one of the 22 cases(21.57%)as a team,give the related inspection diagnosis of ventricular premature beat cardiomyopathy cardiomyopathy,22 cases of patients,don’t for "male/female,age 37-53(42.69 ± 2.96)years of age.The remaining 80 cases(78.43%)as control group,80 cases of patients,don’t for 39:41 of male/female,aged 35 to 54(42.78 ±2.76).By contrast,general data contrast with no difference between two groups(P>0.05).2.Patients with ventricular premature beat cause cardiomyopathy inclusion and exclusion criteria included(1)gives the relevant examination confirmed,such as plate movement,coronary angiography,24 h dynamic electrocardiogram examination.eliminate have known the reason of implement qualitative sex heart disease caused by decreased left ventricular function.(2)diagnostic criteria:after exclusion of organic heart disease,preoperative LVEF<50%.And after treatment with effective after radiofrequency ablation,EF>50%or higher EF>15%.The inclusion and exclusion criteria of patients with PVCs—ICM.:The patients had failed to respond at least one antiarrhythmic drugs.or could not be tolerated,PVCs-ICM was defined as an ejection fraction<50%that normalized after ablation or an low ejection fraction that improved by≥10%.Structural heart disease was rule out by echocardiography,stress testing,coronary angiography,coronary CT imaging and/or magnetic resonance imaging.Parameters:to obtain:the study gives patients echocardiography,used in the process of checking instrument manufacturers are American GE company,models for Vivid7 type;Minimum value is 2.0 MHz probe frequency,the maximum of 3.5 MHz.Specific operation as follows:after the patients into medical personnel to guide the patient left side position,maintained steady and breathing rates,and then the electrocardiogram(ecg)were synchronous approach,and then clear the phase.All check index for continuous detection,you usually need to three period measurement,then measure the mean values of three times.Then in the two-dimensional ultrasound guided the LVEDd indicators to measure,known as left ventricular end-diastolic diameter before and after the biggest.In four cavity aspect nowadays plain noodles with Simpson method adopted to LVEF indicators to measure.Also give dynamic electrocardiogram(ecg)in patients with this study,the selection of dynamic electrocardiogram(ecg)System for Holter System Verl2.net,24 h for selected cases of ventricular premature beat load..After radiofrequency ablation of ventricular premature beat load compared with preoperative>80%reduction for ablation successfully.Ventricular premature beat united law of interphase:For lack of clinical data of patients,the study in the related personnel arrangement experienced two doctors help patients examined,observe the relevant indicators.If there was some difference of two physicians examination results,can be both measured data from the mean.If there is a deviation measurement results two doctors,and the deviation rate of more than 10 ms,you must arrange the third physicians involved in the testing and measurement of related indicators.In the operation permission and disable anti-arrhythmic drugs after at least five half-life radiofrequency ablation(RFCA)surgery.Select correct way according to the origin of ventricular premature beat positions are melting,ablation instrument adopts IBI-500-t model for the United States.If the clinical symptoms disappeared or after ablation of ventricular premature beat,the medical personnel to patients with multiple ventricular stimulation in half an hour,and give patients a certain amount of isopropyl adrenaline,dosing intravenous drip,this,in turn,reduce the incidence of ventricular premature beat,for its positive prevention.All analysis was performed with the use of SPSS software version 20.0.Continuous variables are expressed as x±s standard deviation and were compared with Student t test.Categorical variables were compared with x2 test.Groups were compared with t-test or approximate t-test.ResultPremature ventricular contraction-induced cardiomyopathy can be reversed by successful Radiofrequency catheter ablation;Smallter coupling interval width may be more susceptible to the development of cardiomyopathy.