Author(s): Spector ZZ, Seslar SP
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Abstract BACKGROUND: Adults with high premature ventricular contraction burden can develop left ventricular dilation, dysfunction, and strain, consistent with a cardiomyopathy, which is reversible with radiofrequency ablation of the premature ventricular contractions. Evidence in children with similar ectopy burden is limited. We performed a single-centre retrospective review to examine the prevalence of premature ventricular contraction-induced cardiomyopathy, natural history of ventricular ectopy, and progression to ventricular tachycardia in children with frequent premature ventricular contractions. METHODS: Children aged between 6 months and 18 years, with premature ventricular contractions comprising at least 20\% of rhythm on 24-hour Holter monitor, were included in our study. Those with significant structural heart disease, ventricular tachycardia greater than 1\% of rhythm at the time of premature ventricular contraction diagnosis, or family history of cardiomyopathy - except tachycardia-induced - were excluded. Cardiomyopathy was defined by echocardiographic assessment. RESULTS: A total of 36 children met the study criteria; seven patients (19.4\%, 95\% CI 6.2-32.6\%) met the criteria for cardiomyopathy, mostly at initial presentation. Ectopy decreased to <10\% of beats without intervention in 16.7\% (95\% CI 4.3-29.1\%) of the patients. No patient progressed to having ventricular tachycardia as more than 1\% of beats on follow-up Holter. Radiofrequency ablation was performed in three patients without cardiomyopathy. CONCLUSIONS: Our study demonstrates a higher prevalence of cardiomyopathy among children with high premature ventricular contraction burden than that previously shown. Ectopy tended to persist throughout follow-up. These trends suggest the need for a multi-centre study on frequent premature ventricular contractions in children. In the interim, regular follow-up with imaging to evaluate for cardiomyopathy is warranted.
This article was published in Cardiol Young
and referenced in Journal of Pharmacological Reports