Electrocardiographic Characteristics, Identification, and Management of Frequent Premature Ventricular Contractions.
Dimitrios TsiachrisMichail BotisIoannis DoundoulakisLamprini Iro BartsiokaPanagiotis TsioufisAthanasios KordalisChristos-Konstantinos AntoniouKonstantinos TsioufisChristos-Konstantinos AntoniouPublished in: Diagnostics (Basel, Switzerland) (2023)
Premature ventricular complexes (PVCs) are frequently encountered in clinical practice. The association of PVCs with adverse cardiovascular outcomes is well established in the context of structural heart disease, yet not so much in the absence of structural heart disease. However, cardiac magnetic resonance (CMR) seems to contribute prognostically in the latter subgroup. PVC-induced myocardial dysfunction refers to the impairment of ventricular function due to PVCs and is mostly associated with a PVC burden > 10%. Surface 12-lead ECG has long been used to localize the anatomic site of origin and multiple algorithms have been developed to differentiate between right ventricular and left ventricular outflow tract (RVOT and LVOT, respectively) origin. Novel algorithms include alternative ECG lead configurations and, lately, sophisticated artificial intelligence methods have been utilized to determine the origins of outflow tract arrhythmias. The decision to therapeutically address PVCs should be made upon the presence of symptoms or the development of PVC-induced myocardial dysfunction. Therapeutic modalities include pharmacological therapy (I-C antiarrhythmic drugs and beta blockers), as well as catheter ablation, which has demonstrated superior efficacy and safety.
Keyphrases
- left ventricular
- catheter ablation
- left atrial
- artificial intelligence
- machine learning
- atrial fibrillation
- deep learning
- magnetic resonance
- heart failure
- hypertrophic cardiomyopathy
- cardiac resynchronization therapy
- acute myocardial infarction
- high glucose
- mitral valve
- aortic stenosis
- clinical practice
- diabetic rats
- big data
- oxidative stress
- left atrial appendage
- pulmonary hypertension
- drug induced
- heart rate
- randomized controlled trial
- emergency department
- risk factors
- computed tomography
- endothelial cells
- stem cells
- clinical trial
- blood pressure
- physical activity
- decision making
- acute coronary syndrome
- sleep quality
- bioinformatics analysis