Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Heart. 2021 Jan;107(1):10-17. doi: 10.1136/heartjnl-2020-317491. Epub 2020 Oct 19.
Premature ventricular complexes (PVCs) are often observed in patients presenting with heart failure with a reduced ejection fraction (HFrEF). PVCs may in some patients be considered to be the cause of heart failure, while in others it may be the consequence of heart failure. PVCs are important prognostic markers in HFrEF. The uncertainty whether PVCs are the cause or effect in HFrEF impacts clinical decision making. In this review, we discuss the complexity of the cause-effect relationship between PVCs and HFrEF. We demonstrate a workflow with the use of a trial period of amiodarone that may discover whether the reduced LVEF is reversible, the symptoms are due to PVCs and whether biventricular pacing can be increased by the reduction of PVCs. The use of non-invasive and invasive (high-density) mapping techniques may help to improve accuracy and efficacy in the treatment of PVC, which will be demonstrated. With these results in mind, we conclude this review highlighting the future directions for PVC research and treatment.
室性期前收缩（PVCs）在射血分数降低的心力衰竭（HFrEF）患者中经常观察到。在一些患者中，PVCs 可能被认为是心力衰竭的原因，而在另一些患者中，它可能是心力衰竭的结果。PVCs 是 HFrEF 的重要预后标志物。PVCs 在 HFrEF 中是原因还是结果的不确定性影响临床决策。在这篇综述中，我们讨论了 PVCs 和 HFrEF 之间因果关系的复杂性。我们展示了一个使用胺碘酮试验期的工作流程，该流程可以发现左心室射血分数降低是否可逆，症状是否因 PVCs 引起，以及双心室起搏是否可以通过减少 PVCs 来增加。非侵入性和侵入性（高密度）映射技术的使用可能有助于提高 PVC 治疗的准确性和疗效，这将得到证明。有了这些结果，我们总结了这篇综述，强调了 PVC 研究和治疗的未来方向。
