Clinical Spectrum and Prognostic Factors of Pediatric Ventricular Tachycardia

Abstract

Background: There have been no studies on the clinical characteristics and prognostic factors of pediatric ventricular tachycardia (VT). Methods and Results:Eighty-one patients with pediatric VT were studied retrospectively at a single center. The median follow-up period was 6.0 years (0.7-23.5 years). Patients were categorized into 6 groups: idiopathic VT (IVT, n=37), catecholaminergic polymorphic VT (CPVT, n=10), congenital heart disease-associated VT (n=15), myocarditis-associated VT (n=8), cardiomyopathy-associated VT (CMP-VT, n=5) and miscellaneous. The age distribution of VT had 2 peaks (infant and teenager). VT with left bundle branch block configuration was more frequently nonsustained than VT with right bundle branch block configuration (61% vs 8%). Although 22% were asymptomatic, 38% experienced syncope or seizure and 16% had cardiac arrest. The overall mortality rate was 7.4%. The expected life span without cardiac arrest was <4 years in the CMP-VT group and the 10-year survival rate in CPVT patients was approximately 55%. Onset at infancy, monomorphic type and transcatheter/surgical ablation were related to the successful resolution of VT. Logistic regression analysis revealed that CPVT, CMP-VT, polymorphic VT and sustained VT were significantly correlated with death or cardiac arrest. Conclusions:The clinical features and prognosis of pediatric VT differed with the VT type, clinical categories and onset age. Accurate diagnosis and proper treatment according to the clinical categories may improve the outcome. (Circ J 2010; 74: 1951 - 1958

Outcome of Pregnancy and Effects on the Right Heart in Women With Repaired Tetralogy of Fallot

“…16 An arrhythmogenic effect could cause significant hemodynamic compromise in both the mother and fetus in women with repaired TOF with subclinical LV intolerance and RV dilation during pregnancy. 17, 18 Therefore, arrhythmia and an enlarged RV should be viewed with particular caution in the pregnancy management of these women.…”

Idiopathic Cardiomyopathies in Korean Children - 9-Year Korean Multicenter Study -

“…In particular, some cases of these types of CMP were extremely fatal, leading to cardiac death within 24 months after diagnosis, as reported in other studies. [13][14][15][16][17] Regarding the prognosis of patients with CMP with or without a family history in prior research studies, familial history of sudden death is a well-known risk factor for patients with poor prognosis. In this study, comparison of the survival curves of each patient belonging to each subgroup of CMP regarding family history found no statistically significant difference between them.…”

Electrophysiological Characteristics of Idiopathic Ventricular Tachycardia in Children

“…Organic heart disease was excluded by physical examination, chest radiography, and echocardiography. The 46 children (18 males, 28 females) with a mean age of 11.7± 3.4 years (4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19) were included in this study. Their mean body weight was 41.6±14.2 kg (17.9-71.6 kg), mean body length 147.1±18.3 cm (109.4-178.0 cm), and mean body surface area 1.30±0.30 m 2 (0.74-1.85 m 2 ).…”