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Early detection of electromechanical dysfunction in patients with idiopathic premature ventricular contractions
Author(s) -
Walia Rohit,
Chang ShihLin,
Lin YennJiang,
Lo LiWei,
Hu Yu Feng,
Chao TzeFan,
Chung FaPo,
Liao JoNan,
Lin ChinYu,
Chang YaoTing,
Lin ChungHsing,
Te Abigail Louise D.,
Yamada Shinya,
Chen ShihAnn,
Tsao HsuanMing
Publication year - 2019
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/pace.13650
Subject(s) - medicine , cardiology , ejection fraction , heart failure
Background Premature ventricular contractions (PVCs) induced by subtle cardiac dysfunction are missed by echocardiography. We evaluated acoustic cardiography for detection of early electromechanical dysfunction in patients with idiopathic PVCs and normal left ventricular ejection fraction (LVEF), and investigated the impact of radiofrequency ablation (RFA) in reversing this adverse effect. Methods Eighty‐six patients with PVCs and 33 normal controls having normal LVEF were studied. Fifty PVC patients were in the ablation group and 36 in the nonablation group. %Electromechanical activation time (%EMAT), %left ventricular systolic time (%LVST), third (S3) and fourth heart sound (S4), and systolic dysfunction index (SDI) during sinus rhythm (SR) were measured by acoustic cardiography (Audicor, Inovise Medical, Inc., Beaverton, OR, USA) pre‐ and postablation. In 28 patients, acoustic parameters were compared during SR without PVCs, and SR with single PVC, ≥ 2 PVCs, or ventricular tachycardia over 10‐second Audicor recording in a single patient at different times. Twenty‐four‐hour acoustic cardiographic and acoustic cardiographic Holter recording were used to assess the impact of PVC burden on electromechanical function in 41 patients. Results %EMAT, S3, S4, and SDI showed significant worsening in the PVC versus control group. %EMAT and SDI were worsened with increasing PVC number in a 10‐second strip. %EMAT showed significant linear increment with increasing PVC burden. There was a significant improvement in %EMAT, %LVST, S3, S4, and SDI postablation in patients with PVCs. Conclusion Acoustic cardiography can detect PVC‐induced minor electromechanical dysfunction in patients with normal LVEF. RFA can reverse this adverse effect.