Premature contraction is the most common arrhythmia in cardiology's consultation. Premature ventricular contraction (PVC) is found on 2–3% of electrocardiograms (ECG), in 77% cases without heart disorder.

Determine the risk of developing a PVC induced cardiomyopathy (CMR) with a clinical algorithm.

Between 2007 and 2017 were included retrospectively all patients addressed to Laveran military hospital for PVC found on ECG during an enlistment's consultation. The patients aged more than 35 years were excluded.

Seventy-four masculine patients were included, the average age of patients was 25 years and they were asymptomatic for 95% of them. Predominantly, PVC came from right ventricle (51%), and epicardic origin was only found in 13,5% cases. Thanks to cardiac MRI we detected 10 heart disorders (13.5%): 3 arrhythmogenic right ventricular dysplasia, 6 arrhythmia induced cardiomyopathy and 1 residua of myocarditis. In the CMR group, PVC burden was significantly higher (18141 vs 6713, P=0.049) and the PVC QRS duration (PVC-QRSd) was superior (158 vs 139, P=0.206). On transthoracic echocardiography anomalies left ventricle ejection fraction were significantly more present (P=0.008). Cardiac MRI was systematically performed and confirmed CMR's diagnose. Thanks to literature's data and our results: symptomatic patients with PVC-QRSd>156 ms with 100% sensitivity and 80% specificity seemed to have a strong risk to develop a CMR. With same sensibility et specificity for asymptomatic patients, according to PVC-QRSd, PVC burden, left ventricle and epicardic origins, balancing every criterion, CMR risk factor was determined. Algorithms have to be tested on a largest population and clinical follow-up is required.

A rare clinical study which heads the key place of clinical examination and ECG analysis to determine CMR's risk. Cardiac MRI confirms her major place for the diagnostic and the follow-up.