Circadian variability patterns predict and guide premature ventricular contraction ablation procedural inducibility and outcomes
Infrequent intraprocedural premature ventricular complexes (PVCs) may impede radiofrequency catheter ablation (RFA) outcome, and pharmacologic induction is unpredictable. The purpose of this study was to determine whether PVC circadian variation could help predict drug response. Consecutive patients...
Gespeichert in:
| Veröffentlicht in: | Heart rhythm 2018-01, Vol.15 (1), p.99-106 |
|---|---|
| Hauptverfasser: | , , , , , , , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 106 |
|---|---|
| container_issue | 1 |
| container_start_page | 99 |
| container_title | Heart rhythm |
| container_volume | 15 |
| creator | Hamon, David Abehsira, Guillaume Gu, Kai Liu, Albert Blaye-Felice Sadron, Marie Billet, Sophie Kambur, Thomas Swid, Mohammed Amer Boyle, Noel G. Dandamudi, Gopi Maury, Philippe Chen, Minglong Miller, John M. Lellouche, Nicolas Shivkumar, Kalyanam Bradfield, Jason S. |
| description | Infrequent intraprocedural premature ventricular complexes (PVCs) may impede radiofrequency catheter ablation (RFA) outcome, and pharmacologic induction is unpredictable.
The purpose of this study was to determine whether PVC circadian variation could help predict drug response.
Consecutive patients referred for RFA with detailed Holter monitoring and frequent monomorphic PVCs were included. Patients were divided into 3 groups based on hourly PVC count relationship to corresponding mean heart rate (HR) during each of the 24 hours on Holter: fast-HR-dependent PVC (F-HR-PVC) type for a positive correlation (Pearson, P |
| doi_str_mv | 10.1016/j.hrthm.2017.07.034 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1925510322</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S154752711730958X</els_id><sourcerecordid>1925510322</sourcerecordid><originalsourceid>FETCH-LOGICAL-c404t-2fdd8c35806af179beadf9ca703d74ee31ae99a959ea6e24ed04abc2dcb8a533</originalsourceid><addsrcrecordid>eNp9kElrHDEQhUVwiJfkFwSCjr70REur1X3IwQx2HDDk4ruolqpjDb1MtAz45p8etWeco6GgHuLVK9VHyFfONpzx5vtu8xTS07QRjOsNKyXrD-SCK9VUstX8bNW1rpTQ_JxcxrhjTHQNk5_IuWh1o1irL8jL1gcLzsNMDxA89H706ZnuISUMc6T7gM7bRGF29E_2DteXCVIOSA84p-BtHiFQuxQNNvllptCP8Cr2YbHocoCR-tll60_pa9iSk10mjJ_JxwHGiF9O_Yo83t0-bu-rh98_f21vHipbszpVYnCutVK1rIGB665HcENnQTPpdI0oOWDXQac6hAZFjY7V0FvhbN-CkvKKXB9jy5_-ZozJTD5aHEeYccnR8E4oxZkUoljl0WrDEmPAweyDnyA8G87MSt7szCt5s5I3rJSsy9S304LcT-j-z7yhLoYfRwOWKw8eg4nW41wA-YA2Gbf4dxf8Awwvmy8</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1925510322</pqid></control><display><type>article</type><title>Circadian variability patterns predict and guide premature ventricular contraction ablation procedural inducibility and outcomes</title><source>Elsevier ScienceDirect Journals</source><creator>Hamon, David ; Abehsira, Guillaume ; Gu, Kai ; Liu, Albert ; Blaye-Felice Sadron, Marie ; Billet, Sophie ; Kambur, Thomas ; Swid, Mohammed Amer ; Boyle, Noel G. ; Dandamudi, Gopi ; Maury, Philippe ; Chen, Minglong ; Miller, John M. ; Lellouche, Nicolas ; Shivkumar, Kalyanam ; Bradfield, Jason S.</creator><creatorcontrib>Hamon, David ; Abehsira, Guillaume ; Gu, Kai ; Liu, Albert ; Blaye-Felice Sadron, Marie ; Billet, Sophie ; Kambur, Thomas ; Swid, Mohammed Amer ; Boyle, Noel G. ; Dandamudi, Gopi ; Maury, Philippe ; Chen, Minglong ; Miller, John M. ; Lellouche, Nicolas ; Shivkumar, Kalyanam ; Bradfield, Jason S.</creatorcontrib><description>Infrequent intraprocedural premature ventricular complexes (PVCs) may impede radiofrequency catheter ablation (RFA) outcome, and pharmacologic induction is unpredictable.
The purpose of this study was to determine whether PVC circadian variation could help predict drug response.
Consecutive patients referred for RFA with detailed Holter monitoring and frequent monomorphic PVCs were included. Patients were divided into 3 groups based on hourly PVC count relationship to corresponding mean heart rate (HR) during each of the 24 hours on Holter: fast-HR-dependent PVC (F-HR-PVC) type for a positive correlation (Pearson, P <.05), slow-HR-dependent PVC (S-HR-PVC) type for a negative correlation, and independent-HR-PVC (I-HR-PVC) when no correlation was found.
Fifty-one of the 101 patients (50.5%) had F-HR-PVC, 39.6% I-HR-PVC, and 9.9% S-HR-PVC; 30.7% had infrequent intraprocedural PVC requiring drug infusion. The best predictor of infrequent PVC was number of hours with PVC count <120/h on Holter (area under the curve 0.80, sensitivity 83.9%, specificity 74.3%, for ≥2 h). Only F-HR-PVC patients responded to isoproterenol. Isoproterenol washout or phenylephrine infusion was successful for the 3 S-HR-PVC patients, and no drug could increase PVC frequency in the 12 I-HR-PVC patients. Long-term RFA success rate in patients with frequent PVCs at baseline (82.9%) was similar to those with infrequent PVC who responded to a drug (77.8%; P = .732) but significantly higher than for those who did not respond to any drug (15.4%; P <.0001).
A simple analysis of Holter PVC circadian variability provides incremental value to guide pharmacologic induction of PVCs during RFA and predict outcome. Patients with infrequent I-HR-PVC had the least successful outcomes from RF ablation.</description><identifier>ISSN: 1547-5271</identifier><identifier>EISSN: 1556-3871</identifier><identifier>DOI: 10.1016/j.hrthm.2017.07.034</identifier><identifier>PMID: 28765087</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Autonomic nervous system ; Circadian profile ; Isoproterenol ; Premature ventricular complexes ; Radiofrequency ablation</subject><ispartof>Heart rhythm, 2018-01, Vol.15 (1), p.99-106</ispartof><rights>2017 Heart Rhythm Society</rights><rights>Copyright © 2017 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c404t-2fdd8c35806af179beadf9ca703d74ee31ae99a959ea6e24ed04abc2dcb8a533</citedby><cites>FETCH-LOGICAL-c404t-2fdd8c35806af179beadf9ca703d74ee31ae99a959ea6e24ed04abc2dcb8a533</cites><orcidid>0000-0002-0277-8719 ; 0000-0002-2141-8014</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S154752711730958X$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28765087$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hamon, David</creatorcontrib><creatorcontrib>Abehsira, Guillaume</creatorcontrib><creatorcontrib>Gu, Kai</creatorcontrib><creatorcontrib>Liu, Albert</creatorcontrib><creatorcontrib>Blaye-Felice Sadron, Marie</creatorcontrib><creatorcontrib>Billet, Sophie</creatorcontrib><creatorcontrib>Kambur, Thomas</creatorcontrib><creatorcontrib>Swid, Mohammed Amer</creatorcontrib><creatorcontrib>Boyle, Noel G.</creatorcontrib><creatorcontrib>Dandamudi, Gopi</creatorcontrib><creatorcontrib>Maury, Philippe</creatorcontrib><creatorcontrib>Chen, Minglong</creatorcontrib><creatorcontrib>Miller, John M.</creatorcontrib><creatorcontrib>Lellouche, Nicolas</creatorcontrib><creatorcontrib>Shivkumar, Kalyanam</creatorcontrib><creatorcontrib>Bradfield, Jason S.</creatorcontrib><title>Circadian variability patterns predict and guide premature ventricular contraction ablation procedural inducibility and outcomes</title><title>Heart rhythm</title><addtitle>Heart Rhythm</addtitle><description>Infrequent intraprocedural premature ventricular complexes (PVCs) may impede radiofrequency catheter ablation (RFA) outcome, and pharmacologic induction is unpredictable.
The purpose of this study was to determine whether PVC circadian variation could help predict drug response.
Consecutive patients referred for RFA with detailed Holter monitoring and frequent monomorphic PVCs were included. Patients were divided into 3 groups based on hourly PVC count relationship to corresponding mean heart rate (HR) during each of the 24 hours on Holter: fast-HR-dependent PVC (F-HR-PVC) type for a positive correlation (Pearson, P <.05), slow-HR-dependent PVC (S-HR-PVC) type for a negative correlation, and independent-HR-PVC (I-HR-PVC) when no correlation was found.
Fifty-one of the 101 patients (50.5%) had F-HR-PVC, 39.6% I-HR-PVC, and 9.9% S-HR-PVC; 30.7% had infrequent intraprocedural PVC requiring drug infusion. The best predictor of infrequent PVC was number of hours with PVC count <120/h on Holter (area under the curve 0.80, sensitivity 83.9%, specificity 74.3%, for ≥2 h). Only F-HR-PVC patients responded to isoproterenol. Isoproterenol washout or phenylephrine infusion was successful for the 3 S-HR-PVC patients, and no drug could increase PVC frequency in the 12 I-HR-PVC patients. Long-term RFA success rate in patients with frequent PVCs at baseline (82.9%) was similar to those with infrequent PVC who responded to a drug (77.8%; P = .732) but significantly higher than for those who did not respond to any drug (15.4%; P <.0001).
A simple analysis of Holter PVC circadian variability provides incremental value to guide pharmacologic induction of PVCs during RFA and predict outcome. Patients with infrequent I-HR-PVC had the least successful outcomes from RF ablation.</description><subject>Autonomic nervous system</subject><subject>Circadian profile</subject><subject>Isoproterenol</subject><subject>Premature ventricular complexes</subject><subject>Radiofrequency ablation</subject><issn>1547-5271</issn><issn>1556-3871</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><recordid>eNp9kElrHDEQhUVwiJfkFwSCjr70REur1X3IwQx2HDDk4ruolqpjDb1MtAz45p8etWeco6GgHuLVK9VHyFfONpzx5vtu8xTS07QRjOsNKyXrD-SCK9VUstX8bNW1rpTQ_JxcxrhjTHQNk5_IuWh1o1irL8jL1gcLzsNMDxA89H706ZnuISUMc6T7gM7bRGF29E_2DteXCVIOSA84p-BtHiFQuxQNNvllptCP8Cr2YbHocoCR-tll60_pa9iSk10mjJ_JxwHGiF9O_Yo83t0-bu-rh98_f21vHipbszpVYnCutVK1rIGB665HcENnQTPpdI0oOWDXQac6hAZFjY7V0FvhbN-CkvKKXB9jy5_-ZozJTD5aHEeYccnR8E4oxZkUoljl0WrDEmPAweyDnyA8G87MSt7szCt5s5I3rJSsy9S304LcT-j-z7yhLoYfRwOWKw8eg4nW41wA-YA2Gbf4dxf8Awwvmy8</recordid><startdate>201801</startdate><enddate>201801</enddate><creator>Hamon, David</creator><creator>Abehsira, Guillaume</creator><creator>Gu, Kai</creator><creator>Liu, Albert</creator><creator>Blaye-Felice Sadron, Marie</creator><creator>Billet, Sophie</creator><creator>Kambur, Thomas</creator><creator>Swid, Mohammed Amer</creator><creator>Boyle, Noel G.</creator><creator>Dandamudi, Gopi</creator><creator>Maury, Philippe</creator><creator>Chen, Minglong</creator><creator>Miller, John M.</creator><creator>Lellouche, Nicolas</creator><creator>Shivkumar, Kalyanam</creator><creator>Bradfield, Jason S.</creator><general>Elsevier Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-0277-8719</orcidid><orcidid>https://orcid.org/0000-0002-2141-8014</orcidid></search><sort><creationdate>201801</creationdate><title>Circadian variability patterns predict and guide premature ventricular contraction ablation procedural inducibility and outcomes</title><author>Hamon, David ; Abehsira, Guillaume ; Gu, Kai ; Liu, Albert ; Blaye-Felice Sadron, Marie ; Billet, Sophie ; Kambur, Thomas ; Swid, Mohammed Amer ; Boyle, Noel G. ; Dandamudi, Gopi ; Maury, Philippe ; Chen, Minglong ; Miller, John M. ; Lellouche, Nicolas ; Shivkumar, Kalyanam ; Bradfield, Jason S.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c404t-2fdd8c35806af179beadf9ca703d74ee31ae99a959ea6e24ed04abc2dcb8a533</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Autonomic nervous system</topic><topic>Circadian profile</topic><topic>Isoproterenol</topic><topic>Premature ventricular complexes</topic><topic>Radiofrequency ablation</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hamon, David</creatorcontrib><creatorcontrib>Abehsira, Guillaume</creatorcontrib><creatorcontrib>Gu, Kai</creatorcontrib><creatorcontrib>Liu, Albert</creatorcontrib><creatorcontrib>Blaye-Felice Sadron, Marie</creatorcontrib><creatorcontrib>Billet, Sophie</creatorcontrib><creatorcontrib>Kambur, Thomas</creatorcontrib><creatorcontrib>Swid, Mohammed Amer</creatorcontrib><creatorcontrib>Boyle, Noel G.</creatorcontrib><creatorcontrib>Dandamudi, Gopi</creatorcontrib><creatorcontrib>Maury, Philippe</creatorcontrib><creatorcontrib>Chen, Minglong</creatorcontrib><creatorcontrib>Miller, John M.</creatorcontrib><creatorcontrib>Lellouche, Nicolas</creatorcontrib><creatorcontrib>Shivkumar, Kalyanam</creatorcontrib><creatorcontrib>Bradfield, Jason S.</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Heart rhythm</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hamon, David</au><au>Abehsira, Guillaume</au><au>Gu, Kai</au><au>Liu, Albert</au><au>Blaye-Felice Sadron, Marie</au><au>Billet, Sophie</au><au>Kambur, Thomas</au><au>Swid, Mohammed Amer</au><au>Boyle, Noel G.</au><au>Dandamudi, Gopi</au><au>Maury, Philippe</au><au>Chen, Minglong</au><au>Miller, John M.</au><au>Lellouche, Nicolas</au><au>Shivkumar, Kalyanam</au><au>Bradfield, Jason S.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Circadian variability patterns predict and guide premature ventricular contraction ablation procedural inducibility and outcomes</atitle><jtitle>Heart rhythm</jtitle><addtitle>Heart Rhythm</addtitle><date>2018-01</date><risdate>2018</risdate><volume>15</volume><issue>1</issue><spage>99</spage><epage>106</epage><pages>99-106</pages><issn>1547-5271</issn><eissn>1556-3871</eissn><abstract>Infrequent intraprocedural premature ventricular complexes (PVCs) may impede radiofrequency catheter ablation (RFA) outcome, and pharmacologic induction is unpredictable.
The purpose of this study was to determine whether PVC circadian variation could help predict drug response.
Consecutive patients referred for RFA with detailed Holter monitoring and frequent monomorphic PVCs were included. Patients were divided into 3 groups based on hourly PVC count relationship to corresponding mean heart rate (HR) during each of the 24 hours on Holter: fast-HR-dependent PVC (F-HR-PVC) type for a positive correlation (Pearson, P <.05), slow-HR-dependent PVC (S-HR-PVC) type for a negative correlation, and independent-HR-PVC (I-HR-PVC) when no correlation was found.
Fifty-one of the 101 patients (50.5%) had F-HR-PVC, 39.6% I-HR-PVC, and 9.9% S-HR-PVC; 30.7% had infrequent intraprocedural PVC requiring drug infusion. The best predictor of infrequent PVC was number of hours with PVC count <120/h on Holter (area under the curve 0.80, sensitivity 83.9%, specificity 74.3%, for ≥2 h). Only F-HR-PVC patients responded to isoproterenol. Isoproterenol washout or phenylephrine infusion was successful for the 3 S-HR-PVC patients, and no drug could increase PVC frequency in the 12 I-HR-PVC patients. Long-term RFA success rate in patients with frequent PVCs at baseline (82.9%) was similar to those with infrequent PVC who responded to a drug (77.8%; P = .732) but significantly higher than for those who did not respond to any drug (15.4%; P <.0001).
A simple analysis of Holter PVC circadian variability provides incremental value to guide pharmacologic induction of PVCs during RFA and predict outcome. Patients with infrequent I-HR-PVC had the least successful outcomes from RF ablation.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>28765087</pmid><doi>10.1016/j.hrthm.2017.07.034</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-0277-8719</orcidid><orcidid>https://orcid.org/0000-0002-2141-8014</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1547-5271 |
| ispartof | Heart rhythm, 2018-01, Vol.15 (1), p.99-106 |
| issn | 1547-5271 1556-3871 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1925510322 |
| source | Elsevier ScienceDirect Journals |
| subjects | Autonomic nervous system Circadian profile Isoproterenol Premature ventricular complexes Radiofrequency ablation |
| title | Circadian variability patterns predict and guide premature ventricular contraction ablation procedural inducibility and outcomes |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-09T03%3A24%3A31IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Circadian%20variability%20patterns%20predict%20and%20guide%20premature%20ventricular%20contraction%20ablation%20procedural%20inducibility%20and%20outcomes&rft.jtitle=Heart%20rhythm&rft.au=Hamon,%20David&rft.date=2018-01&rft.volume=15&rft.issue=1&rft.spage=99&rft.epage=106&rft.pages=99-106&rft.issn=1547-5271&rft.eissn=1556-3871&rft_id=info:doi/10.1016/j.hrthm.2017.07.034&rft_dat=%3Cproquest_cross%3E1925510322%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1925510322&rft_id=info:pmid/28765087&rft_els_id=S154752711730958X&rfr_iscdi=true |