Lee Andrea K Y, Deyell Marc W
Heart Rhythm Services, Department of Medicine, Division of Cardiology, University of British Columbia, Vancouver, British Columbia, Canada.
Curr Opin Cardiol. 2016 Jan;31(1):1-10. doi: 10.1097/HCO.0000000000000236.
There has been a resurgent interest in frequent premature ventricular contractions (PVCs) led by the novel concept that they may be a potential cause of, or at least contribute to, cardiomyopathy. This review evaluates recent advances in our understanding of PVC-induced cardiomyopathy.
Recent studies have focused on identifying the predictors of PVC-induced cardiomyopathy, with the most consistent predictors being PVC burden and PVC QRS duration. Multiple studies have investigated the effect of catheter ablation on PVC burden and resultant left ventricular function, with the efficacy of catheter ablation and the overall PVC response rates varying between 60 and 88%. After successful ablation, the rates of improvement in left ventricular ejection fraction have varied between 47 and 100%. A recent study raises the question that perhaps even a lower PVC burden could result in PVC cardiomyopathy and adverse outcomes.
There is an increasing body of literature supporting a causal role of frequent PVCs in the development of left ventricular dysfunction. Effective therapy for PVCs exists; however, the optimal indications for therapy have yet to be determined.
频繁室性早搏（PVC）引发了新的关注热潮，因为有新观点认为它们可能是心肌病的潜在病因，或者至少对心肌病有促成作用。本综述评估了我们对PVC诱发心肌病认识的最新进展。
近期研究聚焦于确定PVC诱发心肌病的预测因素，最一致的预测因素是PVC负荷和PVC QRS时限。多项研究调查了导管消融对PVC负荷及由此产生的左心室功能的影响，导管消融的疗效和总体PVC反应率在60%至88%之间有所不同。成功消融后，左心室射血分数的改善率在47%至100%之间。最近一项研究提出了一个问题，即或许即使较低的PVC负荷也可能导致PVC心肌病和不良后果。
越来越多的文献支持频繁PVC在左心室功能障碍发展中起因果作用。存在针对PVC的有效治疗方法；然而，治疗的最佳指征尚未确定。
