Premature ventricular contraction (PVC)-induced cardiomyopathy is an increasingly recognized cause of reversible cardiomyopathy. Peripartum cardiomyopathy (PPCM) may be complicated by frequent PVCs. To the best of our knowledge, successful reversal of PVC-induced cardiomyopathy following radiofrequency ablation (RFA) in the setting of PPCM has not been previously reported.
A 36-year-old woman developed progressive dyspnea and orthopnea after her second pregnancy. Six weeks after delivery, echocardiogram demonstrated severe left ventricular (LV) dilation with an LV end-diastolic diameter (LVEDD) of 6.9 cm and an LVEF of 25%. She was diagnosed with PPCM and treated medically with guideline-directed heart failure therapy. A wearable cardioverter-defibrillator was prescribed for primary prevention of sudden death. Tracings from the wearable cardioverterdefibrillator reviewed frequent PVCâs. Nine months post-delivery, 24-hour Holter captured 27,422 PVCs, prompting initiation of amiodarone. Three months later, 24-hour Holter monitor captured 31,697 PVCs. Echocardiography showed LVEF had improved to 43% but LV dilatation persisted (LVEDD 6.3 cm). Amiodarone was discontinued and she was referred for RFA for
symptomatic amiodarone-refractory PVCs. Ventricular arrhythmias and frequent PVCs may occur in patients with PPCM, possibly due to LV dilatation and systolic dysfunction. This case illustrates the successful utilization of RFA to treat PVC-induced cardiomyopathy complicating PPCM. Jackson Liang, Radiofrequency ablation for PVC-induced cardiomyopathy complicating peripartum cardiomyopathy
Last date updated on June, 2014