Evaluation of the prevalence and prognosis of various types of premature ventricular contractions (PVCs) following catheter ablation in patients at afshar hospital, yazd, iran (2015–2020)

Objectives: Premature ventricular contraction (PVC) is a common cardiac arrhythmia characterized by heartbeats originating from the ventricles rather than the sinoatrial node. Although radiofrequency catheter ablation (RFCA) is a preferred treatment, its efficacy and prognostic impact remain incompletely established, particularly in developing countries where cardiovascular diseases are a leading cause of mortality. This study aims to investigate the prevalence and predictive outcomes of different PVC types following ablation therapy. Methods: A retrospective, cross-sectional study was performed on all patients who underwent premature ventricular contraction (PVC) ablation at the Catheterization Laboratory of Afshar Hospital in Yazd, Iran, from 2015 to 2020. Patient data were collected using a census sampling approach, based on medical records, with PVC diagnoses confirmed by an electrophysiology specialist. The study examined demographic characteristics, PVC morphology based on surface electrocardiograms (ECGs), and the anatomical origin identified through electrophysiological mapping. Ablation success was defined as a reduction of ≥80% in PVC burden, while recurrence was defined as more than 10% PVCs on a 24-hour Holter monitor during follow-up. Data were analyzed using SPSS software. Results: The study included 75 patients (56% male, 44% female) with a mean age of 47.0 ± 13.7 years. The most common site of PVC origin was the right ventricular outflow tract (RVOT), found in 54.7% of cases. Common comorbidities included hypertension (31%) and diabetes mellitus (11%). Palpitations were the most frequently reported symptom, seen in 63% of patients. The overall success rate of ablation was 81.3%. Complications were rare and included catheter site hematoma (2.7%) and thromboembolism (1.3%). Among patients who had successful ablation, 18% experienced recurrence. A statistically significant relationship was found between the anatomical origin of PVC and ablation success (p < 0.0001). However, the origin of PVCs was not significantly associated with recurrence or the timing of recurrence (p > 0.08). Conclusions: This study identifies palpitations as the primary symptom in patients with premature ventricular contractions (PVCs), which most commonly originate from the ventricular outflow tracts. Hypertension and diabetes mellitus were identified as significant comorbidities. Radiofrequency ablation demonstrated a high success rate, with few complications and a low recurrence rate. Notably, the anatomical origin of PVCs was a substantial predictor of ablation success.