Catheter ablation of premature ventricular contraction-induced cardiomyopathy.

Background: A 44-year-old female presented with a long history of chest pain, palpitations and increasing dyspnea. Electrocardiography and 24 h Holter monitoring revealed multiple premature ventricular complexes (PVCs), and echocardiography demonstrated significant left ventricular dilatation and systolic impairment. After further investigation it was concluded that this cardiomyopathy was secondary to the observed multiple PVCs and that these represented a potential target for treatment.

Investigations: Electrocardiography, echocardiography, cardiac MRI, 24 h Holter monitoring, coronary angiography, tilt testing and invasive electrophysiological testing using a multielectrode array catheter.

Diagnosis: PVC-induced dilated cardiomyopathy.

Management: Electrophysiological mapping and cryoablation of the focus of the ventricular ectopy.