The Association of High Burden Premature Ventricular Contractions With Esophageal/Upper GI Diseases

Seven patients in our clinical program who were diagnosed with high burden (>10%) premature ventricular contractions (PVCs) and concomitant significant upper GI disease with no other significant cardiac history demonstrated a significant reduction in the burden of PVCs following surgical or procedural interventions of the upper GI tract [68.34% reduction, p=0.024). Furthermore, in all cases, the origin of the PVCs was from the base of the right ventricular outflow tract (RVOT). This is the first report in the literature that we are aware of to report this unique association for which we propose a dual mechanism of action of vagally mediated upper GI driven PVCs and a direct anatomical effect of these upper GI anatomies on the right ventricular outflow tract (RVOT) of the heart. These are very prelimary findings that warrant larger clinical and mechanistic studies that may ultimately define a new subset of PVCs for which we propose a term, “E-PVCs”.