Propensity‐score matched comparison of renal and neurohormonal effects of catheter ablation for frequent premature ventricular contractions in patients with and without systolic dysfunction

• Published in: Journal of arrhythmia Vol. 40; no. 2; pp. 306 - 316
• Main Authors: Hiroki, Jiro, Mizukami, Akira, Ueshima, Daisuke, Mashiki, Jun, Miyakuni, Shota, Kono, Toshikazu, Ono, Maki, Miyazaki, Shinsuke, Matsumura, Akihiko, Sasano, Tetsuo
• Format: Journal Article
• Language: English
• Published: Japan John Wiley & Sons, Inc 01.04.2024; Wiley
• Subjects: Ablation; Antiarrhythmics; Arrhythmia; Beta blockers; Blood pressure; Blood tests; B‐type natriuretic peptide; Cardiac arrhythmia; Cardiomyopathy; Cardiovascular disease; Care and treatment; catheter ablation; Catheters; Creatinine; Diagnosis; Drug therapy; Ejection fraction; Electrocardiography; estimated glomerular filtration rate; Health aspects; Heart attacks; Heart failure; Heart surgery; Hypertension; Medical records; Patients; premature ventricular contractions; Stroke; ventricular ejection fraction; Japan; United States > US; ventricular ejection fraction; B‐type natriuretic peptide; catheter ablation; estimated glomerular filtration rate; premature ventricular contractions
• ISSN: 1880-4276; 1883-2148
• DOI: 10.1002/joa3.12989

Background Catheter ablation (CA) for premature ventricular contractions (PVCs) restores cardiac and renal functions in patients with reduced left ventricular ejection fraction (LVEF); however, its effects on preserved EF remain unelucidated. Methods The study cohort comprised 246 patients with a PVC burden of >10% on Holter electrocardiography. Using propensity matching, we compared the changes in B‐type natriuretic peptide (BNP) levels and estimated glomerular filtration rate (eGFR) in patients who underwent CA or did not. Results Postoperative BNP levels were decreased significantly in the CA group, regardless of the degree of LVEF, whereas there was no change in those of the non‐CA group. Among patients who underwent CA, BNP levels decreased from 44.1 to 33.0 pg/mL in those with LVEF ≥50% (p = .002) and from 141.0 to 87.9 pg/mL in those with LVEF <50% (p < .001). Regarding eGFR, postoperative eGFR was significantly improved in the CA group of patients with LVEF ≥50% (from 71.4 to 74.7 mL/min/1.73 m2, p = .006), whereas it decreased in the non‐CA group. A similar trend was observed in the group with a reduced LVEF. Adjusted for propensity score matching, there was a significant decrease in the BNP level and recovery of eGFR after CA in patients with LVEF >50%. Conclusions This study showed that CA for frequent PVCs decreases BNP levels and increases eGFR even in patients with preserved LVEF. We investigated the effects of catheter ablation of multiple premature ventricular contractions on B‐type natriuretic peptide (BNP) and estimated glomerular filtration rate (eGFR) in patients with preserved and reduced ejection fraction (EF), respectively. We found that BNP decreased and eGFR increased after catheter ablation even in patients with preserved EF.