Clinical Electrophysiology -> Ventricular Arrhythmias -> Physiology-Pharmacology D-PO06 - Poster Session VI (ID 26) Poster

D-PO06-056 - Prevalence Of Right Ventricular Dysfunction And Right Ventricular Response To Catheter Ablation Of Premature Ventricular Contractions (ID 688)

Abstract

Background: Premature ventricular contractions (PVCs) can reduce left ventricular (LV) function and ablation of PVCs may improve ejection fraction (EF). Right ventricular (RV) functional sequelae to PVCs and response to catheter ablation are unknown.
Objective: To assess RV function and response to catheter ablation of PVCs.
Methods: Patients undergoing catheter ablation of PVCs received transthoracic echocardiograms (echos) pre- and post-procedure. RV function was quantified using linear tricuspid annular excursion (TAPSE), RV S’, and RV global longitudinal strain (GLS) via 2D speckle tracking. Abnormal RV function was defined as RV GLS <20%.
Results: 33 consecutive patients (age: 63±14; M: 61%) undergoing PVC ablation with available echo data were studied. At 4.1±2.7 month follow up, there was a significant increase in LV EF (45±15 vs. 50±13%; p=0.048) which paralleled decrease in PVC burden (20073±16027 (IQR 7780-28301) vs. 4812±5939 (IQR 35-7674); p≤0.001). In RV parameters, 58% had RV impairment pre- versus 39% post-ablation (p=0.001). RV GLS improved by almost 16% (18.6±5.0 vs. 21.5±4.6%; p=0.001). RV recovery was more common in those with LV recovery than those without (18 vs. 9%; p<0.001). There was no significant change in TAPSE and S’ pre- and post-procedure. Figure illustrates RV parameters and LV EF pre- and post-ablation; change in RV function is detectable via RV GLS whereas conventional RV parameters were unchanged.
Conclusion: RV dysfunction quantified via GLS is highly prevalent among patients undergoing PVC ablation and improves after ablation. RV GLS is a novel parameter capable of detecting subtle changes in RV function among patients undergoing this procedure.
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