Background
The association between premature ventricular complexes (PVCs) and ventricular function has been described in several observational studies, where it has been implied that a higher burden of PVCs plays a causative role in reducing left ventricular ejection fraction (LVEF). To date, however, few studies have examined the association of PVCs and cardiomyopathy on a population level.
Objectives
In this treatment-agnostic, cross-sectional study, the authors examined the association of PVC burden with impaired LVEF.
Methods
We performed an analysis of >50,000 ambulatory and inpatient monitors obtained on patients from January 01, 2018, and May 15, 2025. Subjects with ≥24 hours of monitoring, a PVC burden of ≥5%, and a transthoracic echocardiogram performed within the ambulatory or inpatient stay of the Holter ECG were included. The presence of cardiomyopathy was defined as LVEF <50%. Clinical factors including comorbidities and relevant medications were included and adjusted for.
Results
The investigated sample included a total of 3,220 patients, with age 70.4 ± 12.2 years, female sex in 24.4%. The average PVC burden was 14.1% ± 8.6% (5%-50%). Of 2912 subjects with a transthoracic echocardiogram, the mean LVEF was 45.2% ± 10.7% (10%-74%), with 1567 subjects (53.8%) having an LVEF <50%. 670 patients (23%) had PVC burden >20%. In both unadjusted and adjusted analyses, we found no significant association between percentage of PVCs and LVEF (P = 0.057), nor with PVC burden and depressed left ventricular function (P = 0.52).
Conclusions
We found no evidence that the PVC burden alone is an independent predictor of cardiomyopathy.
