doi:10.1016/j.hrthm.2020.07.037engPenela D.Teres C.Fernández-Armenta J.Aguinaga L.Tercedor L.Soto-Iglesias D.Jauregui, B.Ordóñez A.Acosta J.Bisbal F.Aceña M.Silva E.Chauca A.De Sensi F.Vatasescu R.Sánchez-Millán P.Carballo J.Mont L.Berruezo A.Premature ventricular complex site of origin and ablation outcomes in patients with prior myocardial infarctionART-2021-146831Background Frequent premature ventricular complexes (PVCs) are common after a myocardial infarction (MI), but data on PVC ablation in this population are limited. Objective The purpose of this study was to analyze data on PVC ablation in post-MI patients. Methods Three hundred thirty-two patients with frequent PVCs and left ventricular (LV) dysfunction were prospectively studied. Data from 67 patients (20%; age 63 ± 10 years; 65 men [93%]) with previous MI were compared with the remaining 265 patients. Results PVCs in post-MI patients originate predominantly from the LV (92% LV vs 6% right ventricle [RV]; P <.001). The most frequent sites of origin (SOO) were MI scar in 23 patients (34%) and left ventricular outflow tract (LVOT) in 22 patients (33%). A papillary muscle origin was more frequent in post-MI patients (16% vs 4%; P = .001), whereas an RV outflow tract origin was less frequent (1% vs 33%; P <.001) compared to patients without MI. In post-MI patients, PVC burden decreased from 29% ± 12% at baseline to 4.6% ± 7% (P <.001); left ventricular ejection fraction (LVEF) improved from 33.6% ± 8% to 42% ± 10% (P <.001); and New York Heart Association functional class improved from 2.1 ± 0.7 to 1.4 ± 0.5 points (P <.001) at 12 months. Compared with the remaining 265 patients, there were no differences in acute ablation success (85% vs 85%; P = .45), complication rate (6% vs 6%; P = .41), or absolute improvement in LVEF (8.8 ± 10 vs 9.9 ± 11 absolute points; P = .38). Conclusion PVC ablation significantly improves cardiac function and functional status in post-MI patients. PVCs predominantly originate from MI scar and LVOT. A papillary muscle SOO was found to be strongly associated with previous MI.2021http://zaguan.unizar.es/record/16832410.1016/j.hrthm.2020.07.037http://zaguan.unizar.es/record/168324oai:zaguan.unizar.es:168324HEART RHYTHM 18, 1 (2021), 27 - 33by-nc-ndhttps://creativecommons.org/licenses/by-nc-nd/4.0/deed.esinfo:eu-repo/semantics/openAccess