1. Hemodynamic consequences of premature ventricular contractions: Association of mechanical bradycardia and postextrasystolic potentiation with premature ventricular contraction-induced cardiomyopathy
- Author
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Clément Delmas, Pauline Fournier, Anne Rollin, Michel Galinier, Didier Carrié, Sophie Billet, Marie Sadron Blaye-Felice, Philippe Maury, Pierre Mondoly, Benjamin Monteil, Eve Cariou, and Olivier Lairez
- Subjects
Bradycardia ,Male ,medicine.medical_specialty ,Heart Ventricles ,Cardiomyopathy ,Hemodynamics ,Blood Pressure ,030204 cardiovascular system & hematology ,Postextrasystolic potentiation ,Ventricular contraction ,03 medical and health sciences ,0302 clinical medicine ,Physiology (medical) ,Internal medicine ,Medicine ,Humans ,Arterial Pressure ,030212 general & internal medicine ,Correlation of Data ,business.industry ,Blood Pressure Determination ,Invasive arterial pressure ,Organ Size ,Middle Aged ,medicine.disease ,Ventricular Premature Complexes ,Echocardiography ,cardiovascular system ,Systolic arterial pressure ,Cardiology ,Female ,Cardiac Electrophysiology ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,Cardiomyopathies ,Electrophysiologic Techniques, Cardiac ,Anti-Arrhythmia Agents - Abstract
The relationships between hemodynamic consequences of premature ventricular contractions (PVCs) and development of premature ventricular contraction-induced cardiomyopathy (PVC-CM) have not been investigated.The purpose of this study was to correlate concealed mechanical bradycardia and/or postextrasystolic potentiation (PEP) to PVC-CM.Invasive arterial pressure measurements from 17 patients with PVC-CM and 16 controls with frequent PVCs were retrospectively analyzed. PVCs were considered efficient (ejecting PVCs) when generating a measurable systolic arterial pressure. PEP was defined by a systolic arterial pressure of the post-PVC beat ≥5 mm Hg higher than the preceding sinus beat. Every PVC was analyzed for 10 minutes before ablation, and the electromechanical index (EMi = number of ejecting PVCs/total PVC) and postextrasystolic potentiation index (PEPi = number of PVCs with PEP/total PVC) were calculated.EMi was 29% ± 31% in PVC-CM and 78% ± 20% in controls (P.0001). PEPi was 41% ± 28% in PVC-CM and 14% ± 10% in controls (P = .001). There was no control in groups of low EMi or high PEPi. EMi and PEPi were not significantly correlated to left ventricular dimensions or function in PVC-CM patients. PVC coupling interval was related to both ejecting PVCs and PEP.Patients with PVC-CM more often display nonejecting PVCs and PEP compared to controls.
- Published
- 2018