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Premature ventricular contraction-induced cardiomyopathy in children

Published online by Cambridge University Press:  17 June 2015

Zebulon Z. Spector  and
Stephen P. Seslar
Zebulon Z. Spector*
Affiliation:
Division of Pediatric Cardiology, Seattle Children’s Hospital Heart Center, Seattle, Washington, United States of America
Stephen P. Seslar
Affiliation:
Division of Pediatric Cardiology, Seattle Children’s Hospital Heart Center, Seattle, Washington, United States of America
*
Correspondence to: S. P. Seslar, MD, PhD, Division of Pediatric Cardiology, Seattle Children’s Hospital Heart Center, 4800 Sand Point Way NE, M/S RC.2.820, PO Box 5371, Seattle, WA 98105, United States of America. Tel: 206 987 1417; Fax: 206 987 3839; E-mail: Stephen.Seslar@seattlechildrens.org
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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.

Keywords

Cardiomyopathychildectopypremature ventricular contractions
Type
Original Articles
Information
Cardiology in the Young , Volume 26 , Issue 4 , April 2016 , pp. 711 - 717
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Copyright
© Cambridge University Press 2015 

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