250 - BENIGN PREMATURE VENTRICULAR CONTRACTIONS (PVCS): TREAT, OR NOT TO TREAT?

Workshop Description: Worskhop will include three case-based presentations and cover the following topics:

1) Natural history of PVCs in so-called “normal hearts” and factors associated with a worse prognosis, 2) indications for cardiac MRI in patients with PVCs with normal cardiac echography; and 3) identification of patients with high burden PVCs who would benefit from an aggressive treatment of their ventricular arrhythmia.

Premature ventricular complexes are relatively common in individuals with structurally normal hearts with a prevalence ranging from 3% to 20%.The prognostic significance in the absence of heart disease is still debated. Some studies suggest that asymptomatic or low-symptomatic PVCs have a benign natural course in subjects without obvious structural heart and others show that PVCs increase the risk for structural heart disease even in apparent healthy individuals. Suppressive therapy (catheter ablation or antiarrhythmic drugs,[AADs]) is recommended in the context of symptoms or associated heart failure. Patient with high rates (>10%) PVCs are at risk of developing tachycardiomypathy and some experts recommend prophylactic catheter ablation. However recent publications showed a high rate of spontaneous resolution.

Participants of this workshop will learn about the evaluation of such patients, and specially will learn to recognize features to identify patients with a higher risk of underlying heart disease. Participants will be provided with a 2024 update on the appropriate selection of patients for cardiac MRI and catheter ablation.

This workshop will fulfill the learning needs of those seeking a practical approach to these common and sometimes difficult arrhythmia cases. This workshop will provide participants with a comprehensive and practical approach to premature ventricular contractions and improve everyday practice. Workshop participants will also learn how to interpret the ECG tracings in such cases.

The CHRS and CSMRI Executive and Education Committees planned this workshop. Members of these committees include community and academic cardiologists, electrophysiologists, cardiology residents and allied professionals from diverse practices and experience across Canada. The CHRS/CSMRI Education Committee is composed of representatives from each of the following regions: British Colombia, the Prairie Provinces, Ontario, Quebec, and the Atlantic Provinces. The CHRS/CSMRI Education Committee has developed an objective and balanced representation of the topic of ventricular arrhythmias that is completely free of third-party influence and/or support. A meeting was planned to assess the needs of clinical cardiologists, trainees and internists in the field of arrhythmia management. Selected speakers are representative of diversity in gender and generation as well as the perspective from across Canada.

Interactive and Engagement Activities Description: Each speaker will open with a case presentation relevant to the topic assigned. Each presentation will last 12 minutes and will include 3 questions -and-answers to promote interactive learning via an audience response system. The 12-minute presentations will allow for 36 minutes of presentations and 14 minutes of discussion.