A new approach to radiofrequency catheter ablation of premature ventricular contractions: The diurnal variation index

Background: Radiofrequency catheter ablation (RFA) is a frequently used method in the treatment of premature ventricular contractions (PVCs) resistant to drug therapy. RFA is recommended for patients with PVCs burden >10%. This study was aimed to investigate the presence of other parameters to enhance the indication of ablation in 24-hour rhythm Holter recordings. Methods: 202 patients with >10% PVCs in 24-hour rhythm Holter recordings were included in the study between January 2015 and August 2019. Patients were divided into two groups. Radiofrequency ablation was performed in 163 patients but not in 39 patients. Results: Laboratory findings were compared between two groups. Total cholesterol (p= 0.018), LDL cholesterol (p = 0.013) and triglyceride (p < 0.001) values were significantly higher in the RFA group, When the 24-hour rhythm Holter findings were compared, the diurnal variation index was significantly higher in the RFA group (p < 0.001). Triglyceride (OR: 1.013, 95% CI: 1.001-1.025, p = 0.032) and diurnal variation index (OR: 3.643, 95% CI: 1.440-9.216, p = 0.006) were determined as independent predictors in binominal logistic regression analysis. In the ROC analysis, when the cut-off value of the diurnal variation index was taken as 1.5, it was found that it could predict patients who undergo effective RFA with 76.7% sensitivity and 60% specificity. Conclusion: Diurnal variation index may be a useful parameter for RFA indication with PVC burden in 24-hour rhythm Holter recordings. (c) 2020 Elsevier Inc. All rights reserved.