{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,21]],"date-time":"2026-02-21T21:09:47Z","timestamp":1771708187818,"version":"3.50.1"},"reference-count":32,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2023,9,7]],"date-time":"2023-09-07T00:00:00Z","timestamp":1694044800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Premature ventricular complexes (PVCs) are the most common ventricular arrhythmia that are encountered in the clinical practice. Recent data suggests that high PVC burden may lead to the development of PVC\u2010induced cardiomyopathy (PVC\u2010CM) even in patients without structural heart disease. Treatment for effective suppression of PVCs, can reverse PVC\u2010CM. Both antiarrhythmic drugs (AADs) and catheter ablation (CA) are recognized treatment modalities for any cardiac arrhythmias. However, with increasing preference of CA, the role of AADs needs further defining regarding their efficacy, safety, indications and patient selection to treat PVC\u2010CM.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>To ascertain the role of AADs to treat PVC\u2010CM; whether they are indicated to treat PVC\u2010CM, and if so, when, we interrogated PubMed and other search engines for English language publications with key words premature ventricular complexes (PVCs), cardiomyopathy, anti\u2010arrhythmic drugs, catheter ablation, and pharmacological agents. All publications were carefully reviewed and scrutinized by the authors for their inclusion in the review paper. For illustration of cases, ethical standard was observed as per the 1975 Declaration of Helsinki, and the patient was treated as per the prevailing standard of care. Informed consent was obtained from the patient for conducting the ablation procedure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Our literature search specifically the pharmacological treatment of PVC\u2010CM with AADs revealed significant paradigm shift in treatment approach for PVCs and PVC\u2010induced cardiomyopathy. No major large, randomized control trials of AADs versus CA for PVC\u2010CM were found. We found that beta\u2010blockers and calcium channel blockers are particularly effective in the treatment of PVCs originating from right ventricular outflow tract. For Class Ic AADs \u2010 flecainide and propafenone, small clinical studies showed Class Ic AADs to be effective in PVC suppression, but their usage was not recommended in patients with significant coronary artery disease. Mexiletine was found to have modest effect on PVC suppression. Studies showed sotalol to significantly reduce PVCs frequency in patients receiving both low and high doses. Studies also showed amiodarone to have higher successful PVC suppression, but not recommended as a first\u2010line treatment for patients with idiopathic PVCs in the absence of symptoms and left ventricular dysfunction. For dronedarone, no major clinical data were available.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Based on the available data in the literature, we conclude that AADs play important role in the treatment of PVC\u2010induced cardiomyopathy. However, appropriate patient selection criteria are vitally important, and in general terms AADs are indicated or polymorphic PVCs, epicardial PVCs; and when CA procedure is contraindicated, or not feasible or failed.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jce.16055","type":"journal-article","created":{"date-parts":[[2023,9,7]],"date-time":"2023-09-07T12:57:36Z","timestamp":1694091456000},"page":"574-582","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Are antiarrhythmic agents indicated in premature ventricular complex\u2010induced cardiomyopathy and when?"],"prefix":"10.1111","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4207-0387","authenticated-orcid":false,"given":"Bharat K.","family":"Kantharia","sequence":"first","affiliation":[{"name":"Division of Cardiology Cardiovascular and Heart Rhythm Consultants New York City New York USA"},{"name":"Division of Cardiology Icahn School of Medicine at Mount Sinai New York City New York USA"},{"name":"Division of Cardiology Mount Sinai Hopital\u2010Morningside, St. Luke's New York City New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arti N.","family":"Shah","sequence":"additional","affiliation":[{"name":"Division of Cardiology Cardiovascular and Heart Rhythm Consultants New York City New York USA"},{"name":"Division of Cardiology Icahn School of Medicine at Mount Sinai New York City New York USA"},{"name":"Division of Cardiology NYC Health and Hospitals, Elmhurst Queens New York 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