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European Journal of Heart Failure 2006 8(8):869-873; doi:10.1016/j.ejheart.2006.02.011
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© 2006 European Society of Cardiology

‘Frequent’ ventricular bigeminy – A reversible cause of dilated cardiomyopathy. How frequent is ‘frequent’?

N. Shanmugama,*, T.P. Chuaa and D. Warda,b

a Royal Surrey County Hospital Guildford, United Kingdom
b St George's Hospital London

* Corresponding author. E-mail address: nesan_s{at}hotmail.com


  Abstract

An interesting development in the field of heart failure has been the link between frequent premature ventricular contractions and cardiomyopathy. We report a patient whose frequent ventricular bigeminy resulted in left ventricular impairment that resolved after the use of non-contact mapping during radiofrequency ablation. A review of the literature regarding possible mechanisms is discussed. For the practicing clinician, the question of ‘frequent’ should be taken in context of symptoms and LV function. A single 24-h Holter monitor may not truly reflect the ectopic load. We recommend that if there is associated LV dysfunction and a causal link to frequent PVCs then suppression with radiofrequency ablation is a safe and effective treatment strategy.

Key Words: Dilated cardiomyopathy • Radiofrequency ablation • Ventricular ectopy • Premature ventricular contractions

Received October 2, 2005; Revised January 30, 2006; Accepted February 9, 2006


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