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A New Combined Parameter to Predict Premature Ventricular Complexes Induced Cardiomyopathy: Impact and Recognition of Epicardial Origin.

Predict the Impact of PVC on Myocardial Function Introduction Reversible premature ventricular complexes-induced cardiomyopathy (PVC-CMP) is a well-described, multi-factorial entity. Single predictors, such as PVC burden or QRS duration, may not apply equally to all patients in contemporary unselect...

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Publicado en:Journal of Cardiovascular Electrophysiology Vol. 27; no. 6; pp. 709 - 718
Autores principales: HAMON, DAVID, BLAYE‐FELICE, MARIE SADRON, BRADFIELD, JASON S., CHAACHOUI, NAJIA, TUNG, RODERICK, ELAYI, CLAUDE S., VASEGHI, MARMAR, DHANJAL, TARVINDER S., BOYLE, NOEL G., MAURY, PHILIPPE, SHIVKUMAR, KALYANAM, LELLOUCHE, NICOLAS
Formato: research tables/charts Journal Article
Publicado: Wiley-Blackwell Jun2016
Acceso en línea:Ver este registro en EBSCOhost
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        10453873
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      jtl: Journal of Cardiovascular Electrophysiology
      issn: 10453873
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    pubinfo:
      dt: Jun2016
      vid: 27
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        115862291
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        115862291
        10.1111/jce.12967
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        atl: A New Combined Parameter to Predict Premature Ventricular Complexes Induced Cardiomyopathy: Impact and Recognition of Epicardial Origin.
      aug:
        au:
          HAMON, DAVID
          BLAYE‐FELICE, MARIE SADRON
          BRADFIELD, JASON S.
          CHAACHOUI, NAJIA
          TUNG, RODERICK
          ELAYI, CLAUDE S.
          VASEGHI, MARMAR
          DHANJAL, TARVINDER S.
          BOYLE, NOEL G.
          MAURY, PHILIPPE
          SHIVKUMAR, KALYANAM
          LELLOUCHE, NICOLAS
        affil: Federation de Cardiologie, Hôpital Henri Mondor, Assistance Publique Hôpitaux de Paris and INSERM U955, Créteil France
      sug:
        subj:
          Premature Ventricular Contractions Diagnosis
          Myocardial Diseases Etiology
          Catheter Ablation
          Human
          Prospective Studies
          Descriptive Statistics
          QRS Complex
          Middle Age
          Aged
          Male
          Female
          Odds Ratio
          Confidence Intervals
          Algorithms
          Sensitivity and Specificity
          Ventricular Dysfunction, Left
          Echocardiography
          Coronary Angiography
          Electrophysiology
          T-Tests
          Mann-Whitney U Test
          Variable
          Chi Square Test
          Fisher's Exact Test
          ROC Curve
          P-Value
          Data Analysis Software
          Recovery
          Funding Source
          Middle Aged: 45-64 years
          Aged: 65+ years
          Male
          Female
      ab: Predict the Impact of PVC on Myocardial Function Introduction Reversible premature ventricular complexes-induced cardiomyopathy (PVC-CMP) is a well-described, multi-factorial entity. Single predictors, such as PVC burden or QRS duration, may not apply equally to all patients in contemporary unselected populations including patients with structural heart disease (SHD) or with particular origin such as epicardial (EPI) PVC. We sought to evaluate clinical criteria associated with PVC-CMP notably focusing on the EPI origin impact and ECG recognition and the value of a new composite predictor of PVC-CMP, the PVC-CMP-Index. Methods and Results We studied 107 consecutive patients (69 men; mean age = 56 ± 16 years) with frequent PVC (23.1 ± 11.5%) referred for PVC ablation. Thirty-six patients (33.6%) had an underlying SHD and 25 patients (23.4%) an EPI PVC origin. After a mean follow-up of 22.7 ± 15.3 months, 72.9% achieved a long-term successful ablation and 54.2% had PVC-CMP. PVC-CMP prevalence was significantly higher in patients with an EPI compared to endocardial PVC focus (84.0% vs. 45.1%, respectively, P < 0.001). EPI PVC origin (OR = 68.7 IC95% [3.5-1363], P = 0.005), as well as SHD (OR = 12.3 IC95% [1.6-92.6], P = 0.015), was independent predictor of PVC-CMP. While PVC burden (AUC = 0.78) or PVC-QRS width (AUC = 0.68) independently predicted PVC-CMP, the PVC-CMP-Index (values ≥39) defined as: PVC burden (0-1) × PVC-QRS width (milliseconds) × a constant C (1.28 for SHD or 2 for ECG suggesting EPI origin based on our ECG 3-step algorithm), highly correlated with PVC-CMP (AUC = 0.91, sensitivity = 93%, specificity = 80%). Conclusion We developed a new index, which incorporates PVC burden, QRS width, and presence of SHD or suspected EPI origin that best predicted PVC-CMP.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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