Electrocardiographic predictors of outcome after radiofrequency catheter ablation of frequent non-ischemic premature ventricular complexes

Abstract

Background: Radiofrequency catheter ablation (RCFA) improves or prevents deterioration of left ventricular function in patients with frequent premature ventricular contractions (PVCs). We aim to identify predictors of outcome of this procedure. Methods: This is a retrospective, single center study of patients with frequent non-ischemic PVCs undergoing RFA at our center. Medical charts of 63 patients were reviewed for multiple patient-and PVC-related variables, and analyzed to correlate with acute and chronic procedural outcome. Results: The predominant PVC (pPVC) was acutely terminated in 53 patients (84.1%), > 80% reduced at one to three months in 54 patients (85.7%), and recurred in two patients.The presence or absence of the pPVC 12 hours post-procedure was the single most significant predictor of long-term outcome (sensitivity 94.4%, positive predictive value 96.2%). PVC QRS transition from negative to positive at V3 was significantly associated with acute procedural failure (p-value 0.02); the transition on V4 was significantly associated with procedural outcome showing a 100% success rate both acutely and on follow-up (p-value < 0.05). Patients with failed outcome at one to three months were more likely to have congestive heart failure (p-value 0.025). Conclusion: Acute outcome within 12 hours of non-ischemic PVC ablation is the most significant predictor of outcome at one to three months post procedure. PVC transition at V4 is highly associated with procedural success while transition at V3 might be predictive of failed ablation. © 2019 Lebanese Order of Physicians. All rights reserved.