Burden of Premature Ventricular Complexes and Risk of Cardiomyopathy

Abstract

Background

The association between premature ventricular complexes (PVCs) and ventricular function has been described in several observational studies, where it has been implied that a higher burden of PVCs plays a causative role in reducing left ventricular ejection fraction (LVEF). To date, however, few studies have examined the association of PVCs and cardiomyopathy on a population level.

Objectives

In this treatment-agnostic, cross-sectional study, the authors examined the association of PVC burden with depressed LVEF.

Methods

We performed an analysis of >30,000 ambulatory monitors obtained on patients from April 22, 2017, and February 20, 2023. Subjects with ≥24 hours of monitoring, a PVC burden of ≥5%, and a transthoracic echocardiogram performed within 3 months of monitoring were included. The presence of cardiomyopathy was defined as LVEF <50%. Clinical factors including comorbidities and relevant medications were included and adjusted for.

Results

The included sample included a total of 1,451 patients, with age 68.2 ± 14.5 years, female sex in 39.6%. The average PVC burden was 12.4% ± 7.4% (5%-43.4%). Of 746 subjects with a transthoracic echocardiogram, the mean LVEF was 55.6% ± 9.2% (25%-76.8%), with 171 subjects (22.9%) having an LVEF <50%. In both unadjusted and adjusted analyses, we found no significant association between percentage of PVCs and LVEF (P = 0.78), nor with PVC burden and depressed left ventricular function (P = 0.13).

Conclusions

We found no evidence that the PVC burden alone is an independent predictor of cardiomyopathy.