To the Editor
We read with interest the article by Lee et al1 assessing the potential benefit of a watchful waiting strategy in 100 patients with frequent premature ventricular contractions (PVCs) (>5%/24 hours) and preserved left ventricular ejection fraction (LVEF) of >50%. The most striking result of the current study was the high proportion of patients with spontaneous reduction in PVC frequency during follow-up. In 44% of the patients, spontaneous PVC reduction (<1%/24 hours) was observed at a median follow-up of 15.4 months. Unfortunately, the authors do not provide data on the development of symptoms in the remaining 56% of the cohort with persistent frequent PVCs. Furthermore, the authors focus on systolic LV function for defining PVC-induced cardiomyopathy and do not give information on diastolic LV function. This information is crucial before advocating a policy of watchful waiting in these patients.
There is consensus that the development of PVC-induced…