https://doi.org/10.1007/s00392-025-02737-x
1Universitäts-Herzzentrum Freiburg / Bad Krozingen Klinik für Kardiologie und Angiologie Bad Krozingen, Deutschland; 2Universitäts-Herzzentrum Freiburg / Bad Krozingen Rhythmologie Bad Krozingen, Deutschland; 3Universitäts-Herzzentrum Freiburg / Bad Krozingen Klinik für Kardiologie und Angiologie II Bad Krozingen, Deutschland
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.