Clinical Electrophysiology -> Ventricular Arrhythmias -> Clinical Trials / Outcomes D-PO05 - Poster Session V (ID 39) Poster

D-PO05-223 - Predictors Of Adverse Outcome In Patients With Frequent Premature Ventricular Complexes: The ABC-VT Risk Score (ID 1316)


Background: Patients with frequent PVCs are at risk for developing cardiomyopathy, but there are no established risk stratification criteria.
Objective: To develop a risk score predicting future adverse events in patients with frequent PVCs.
Methods: We analyzed consecutive patients from 2012-2017 undergoing 14-day continuous patch monitoring with frequent PVCs (>5%) and concurrent echocardiography. We identified multivariate predictors of adverse LV remodeling (LVEF<45% or LVEDVI>75 mL/m2). A risk score was created using the log-OR of these predictors and validated prospectively to determine the risk of future adverse events in those with baseline preserved LVEF (>45%). An adverse event was defined as: LVEF decline by 10%, heart failure hospitalization or cardiovascular mortality. Two validation cohorts were used: follow-up from the original derivation cohort (cohort 1) & an independent Korean registry (cohort 2).
Results: The derivation cohort comprised 206 patients (age 65±16; 62% male; 30% cardiomyopathy) with mean daily PVC burden 12±6% (range 7±6% to 18±8%). Independent predictors of adverse remodeling were: superiorly-directed PVC Axis (OR 2.7, 1 point), PVC Burden 10-20% (OR 3.5, 2 points) or >20% (OR 4.4, 3 points), mean PVC Coupling Interval>500ms (OR 4.7, 4 points), Non-sustained VT (OR 5.3, 4 points), comprising the ABC-VT risk score. This score predicted future adverse events in validation cohort 1 (n=134): HR 1.43 [1.19-1.73];p<0.001, Figure) & cohort 2 (n=516): HR 1.22; [1.05-1.42] p=0.01.
Conclusion: The ABC-VT risk score is a simple tool that predicts adverse LV remodeling & future clinical deterioration in patients with frequent PVCs and preserved LV function.