Subclinical Coronary Atherosclerosis in Patients Undergoing Catheter Ablation for Idiopathic Premature Ventricular Complexes

Ahmet Hakan Ateş; Hikmet Yorgun; Uğur Canpolat; Muhammet Dural; Yusuf Ziya Şener; Metin Oksul; Sevilay Karahan; Kudret Aytemir

doi:10.5152/eurjther.2020.20058

Authors

Ahmet Hakan Ateş Department of Cardiology, Hacettepe University School of Medicine, Ankara https://orcid.org/0000-0001-5414-7268
Hikmet Yorgun Department of Cardiology, Hacettepe University School of Medicine, Ankara https://orcid.org/0000-0001-7673-229X
Uğur Canpolat Department of Cardiology, Hacettepe University School of Medicine, Ankara https://orcid.org/0000-0002-4250-1706
Muhammet Dural Department of Cardiology, Eskisehir Osmangazi University School of Medicine, Eskisehir https://orcid.org/0000-0001-7227-8114
Yusuf Ziya Şener Department of Cardiology, Hacettepe University School of Medicine, Ankara https://orcid.org/0000-0001-5151-5133
Metin Oksul Department of Cardiology, Hacettepe University School of Medicine, Ankara https://orcid.org/0000-0002-4759-4868
Sevilay Karahan Department of Biostatistics, Hacettepe University School of Medicine, Ankara https://orcid.org/0000-0002-8692-7266
Kudret Aytemir Department of Cardiology, Hacettepe University School of Medicine, Ankara https://orcid.org/0000-0001-9279-8424

DOI:

https://doi.org/10.5152/eurjther.2020.20058

Keywords:

Coronary artery disease, premature ventricular complex, radiofrequency ablation

Abstract

Objective: Idiopathic premature ventricular complexes (PVC) occur in the absence of clinically apparent structural heart disease (SHD) and are treated effectively with catheter ablation. We aimed to evaluate the association of PVC characteristics with subclinical coronary artery disease (CAD) during catheter ablation.
Methods: A total of 116 patients (age: median 55 years; sex: 58.6% men), without SHD, in whom PVC ablation and coronary angiography had been performed simultaneously were enrolled. PVC localizations were categorized into 4 groups as; right ventricular outflow tract (RVOT), left ventricular outflow tract (LVOT), left ventricle (LV)-body, and right ventricle (RV)-body. PVC frequency was also classified as moderate (5,000–10,000 PVCs/day) and frequent (≥10,000 PVCs/day). Coronary artery stenoses were categorized as normal, non-critical (<50%), and critical (≥50%).
Results: Co-incidental CAD was more frequent among patients with LV-body originated PVCs (non-critical, 51.6 % and critical, 22.6 %); while most of the patients with LVOT, RVOT, and RV-body originated PVCs had normal coronary arteries (58.8%, 56%, and 55.6%, respectively; p=0.019). There was no significant association between PVC frequency and coronary artery lesion severity (p=0.080) or between PVC recurrence and PVC frequency (p=0.748), PVC localization (p=0.188), coronary artery lesion severity (p=0.080), number of involved coronary artery segments (p=0.566), and number of involved coronary artery vessels (p=0.729).
Conclusion: Subclinical CAD was more frequent among patients with LV-body originated idiopathic PVCs. Thus, its routine pre-procedural assessment may be considered for LV-body originated PVCs.

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