Volume 12, Issue 12, Pages (December 2015)

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Date of download: 7/6/2016 Copyright © The American College of Cardiology. All rights reserved. From: Incidence and Predictors of Implantable Cardioverter-Defibrillator.

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Volume 12, Issue 12, Pages 2434-2442 (December 2015) Ablation of frequent PVC in patients meeting criteria for primary prevention ICD implant: Safety of withholding the implant Diego Penela, MD, Juan Acosta, MD, Luis Aguinaga, MD, Luis Tercedor, MD, PhD, Augusto Ordoñez, MD, Juan Fernández-Armenta, MD, PhD, David Andreu, MSc, PhD, Pablo Sánchez, MD, Nuno Cabanelas, MD, Jose Maria Tolosana, MD, PhD, Francesca Vassanelli, MD, Mario Cabrera, MD, Viatcheslav Korshunov, MD, Marta Sitges, MD, PhD, Josep Brugada, MD, PhD, Lluis Mont, MD, PhD, Antonio Berruezo, MD, PhD Heart Rhythm Volume 12, Issue 12, Pages 2434-2442 (December 2015) DOI: 10.1016/j.hrthm.2015.09.011 Copyright © 2015 Heart Rhythm Society Terms and Conditions

Figure 1 Patient classification based on the presence of a previously diagnosed structural heart disease (SHD) and changes in left ventricular ejection fraction (LVEF) during follow-up. Before premature ventricular complex (PVC) ablation, it is possible to classify patients only as those with or without previously diagnosed structural heart disease. After the completion of follow-up, patient can be classified into 4 groups: patients with a previously diagnosed SHD (PVC-worsened cardiomyopathy); patients with no previously diagnosed SHD and normalized LVEF (>50%) after PVC abolition (PVC-induced cardiomyopathy [CM]); patients with no previously diagnosed SHD and improved but not normalized LVEF after PVC abolition (nonischemic heart disease [NIHD] worsened by PVC); and patients without previously diagnosed SHD and without complete PVC abolition. Heart Rhythm 2015 12, 2434-2442DOI: (10.1016/j.hrthm.2015.09.011) Copyright © 2015 Heart Rhythm Society Terms and Conditions

Figure 2 Left ventricular ejection fraction (LVEF) and New York Heart Association (NYHA) functional class progression during follow-up in patients with and without successful sustained ablation (SSA). Heart Rhythm 2015 12, 2434-2442DOI: (10.1016/j.hrthm.2015.09.011) Copyright © 2015 Heart Rhythm Society Terms and Conditions

Figure 3 Decline in primary prevention implantable cardioverter-defibrillator (PP-ICD) indications during follow-up. IHD = ischemic heart disease. Heart Rhythm 2015 12, 2434-2442DOI: (10.1016/j.hrthm.2015.09.011) Copyright © 2015 Heart Rhythm Society Terms and Conditions

Figure 4 Number of patients with primary prevention (PP) implantable cardioverter-defibrillator (ICD) implant indication during follow-up, according to baseline premature ventricular complex (PVC) burden and the persistence of PVC abolition after ablation. Note that at the end of follow-up, ICD implantation was still indicated in only one of the patients with high PVC burden and successful sustained ablation, but was indicated in all patients with PVC burden <13%, regardless of ablation success. Heart Rhythm 2015 12, 2434-2442DOI: (10.1016/j.hrthm.2015.09.011) Copyright © 2015 Heart Rhythm Society Terms and Conditions

Figure 5 Association between the absolute reduction of the baseline premature ventricular complex (PVC) burden (baseline PVC burden [%] – average 6-month and 12-month PVC burden [%]) and the change in left ventricular ejection fraction (LVEF) during follow-up. Heart Rhythm 2015 12, 2434-2442DOI: (10.1016/j.hrthm.2015.09.011) Copyright © 2015 Heart Rhythm Society Terms and Conditions