Frequent Ventricular Premature Contractions in Heart Failure: Prevalence and Prognosis

Principal Investigators

Dr. Marc Deyell, UBC Clinical Assistant Professor, St. Paul’s Hospital

Funding

CIHR Open Operating Grant (2014 – 2015)

Background

The role of frequent premature ventricular contractions (PVCs) in patients with congestive heart failure (CHF) remains poorly understood. Recent evidence suggests that PVCs may be a cause for reversible left ventricular (LV) dysfunction.  This consequence of frequent PVCs has broad implications as it may contribute to ongoing or deteriorating LV dysfunction in CHF. Currently, the impact of frequent PVCs on outcomes in the general CHF population is unknown.

Objectives

  1. To establish the distribution of PVC burden and prevalence of frequent PVCs in CHF patients with LV dysfunction who are receiving optimal therapy.
  2. To evaluate the association between frequent PVCs and adverse outcomes such as death and CHF hospitalizations among CHF patients receiving optimal therapy.

Methodology

This will be a retrospective cohort study of 1286 patients who had dual chamber devices implanted during the Canadian RAFT trial.  PVC burden was automatically recorded during each device follow-up visit and will be extracted and analyzed along with the outcome data collected in the original RAFT trial.

Significance

This study will be the first to demonstrate whether frequent PVCs put CHF patients at higher risk of worsening heart function and death.  Despite the advances over the last 30 years, CHF remains a disease with a poor prognosis. Treatment of CHF patients also consumes a significant amount of health care resources. As effective therapies already exist for treating PVCs in patients with heart failure, this study will provide the basis for evaluating whether PVCs are a new treatment target to improve the health and well-being of patients with CHF.