Premature Ventricular Complex-Induced Cardiomyopathy, a Review: Current Insights, Diagnostic Challenges, and Therapeutic Strategies

TL;DR

This paper reviews PVC-induced cardiomyopathy, a reversible heart condition caused by frequent premature ventricular complexes, and highlights advances in diagnosis and treatment.

Contribution

The paper provides updated insights into diagnostic methods and therapeutic strategies for PVC-induced cardiomyopathy.

Findings

PVC-induced cardiomyopathy is reversible with effective suppression of arrhythmia.

Advances in imaging and ablation therapy have improved diagnosis and treatment outcomes.

Artificial intelligence and computational mapping are emerging as tools for prediction and procedural guidance.

Abstract

Premature Ventricular Complexes (PVCs) are among the most frequent ventricular arrhythmias observed in daily cardiology practice. Although often benign, sustained high ectopic activity can result in left ventricular dysfunction known as PVC-induced Cardiomyopathy (PVC-CMP), a condition that is frequently reversible when the arrhythmia is effectively suppressed. The underlying mechanisms are multifaceted, involving electromechanical dyssynchrony, contractile inefficiency, abnormal calcium cycling, neurohormonal activation, and progressive structural remodeling. The likelihood of developing PVC-CMP varies among individuals and is influenced by electrophysiological and structural factors. Diagnosis relies on prolonged rhythm monitoring, comprehensive multimodality imaging, and demonstration of ventricular recovery after reducing the ectopic burden, which, in turn, confirms causality. Over the past decade, major advances in electrocardiographic mapping, cardiac imaging, and ablation therapy have transformed this field, demonstrating excellent efficacy and safety profiles. In parallel, artificial intelligence and computational mapping are emerging as powerful tools for prediction and procedural guidance. Recognition of PVC-CMP as a distinct, treatable cardiomyopathy highlights the importance of early detection and individualized therapy, offering the prospect of complete functional recovery and the prevention of heart failure progression.

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