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Repetitive ventricular responses to ventricular extrastimulation studies in children and adolescents
1Lillie Frank Abercrombie Section of Cardiology, Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas, USA.
Insights
Premature ventricular extrastimuli during pacing can cause a repetitive ventricular response (V(3)) in children. This V(3) response is a normal finding, even in those without existing ventricular dysrhythmias.
Area of Science:
- Pediatric Cardiology
- Electrophysiology
- Cardiac Pacing
Background:
- Ventricular pacing is a common intervention in pediatric cardiology.
- Understanding the effects of premature ventricular stimuli is crucial for patient management.
Purpose of the Study:
- To investigate the occurrence and characteristics of repetitive ventricular responses (V(3)) following premature ventricular extrastimuli during ventricular pacing in children.
Main Methods:
- Evaluated 22 children undergoing ventricular pacing.
- Administered single premature ventricular extrastimuli at critical coupling intervals.
- Analyzed the morphology, axis, and preceding His bundle depolarization of the V(3) response.
Main Results:
- A repetitive ventricular response (V(3)) was observed in 45% of the children studied.
- The V(3) response showed similar morphology and axis to the premature and paced beats.
- This response was preceded by His bundle depolarization and occurred irrespective of pre-existing ventricular dysrhythmias.
Conclusions:
- The repetitive ventricular response (V(3)) is a normal phenomenon during ventricular stimulation in children.
- Its occurrence does not necessarily indicate underlying ventricular dysrhythmias.
Abstract:
The effect of single premature ventricular extrastimuli during ventricular pacing was evaluated in 22 children with a mean age of 8.8+/-5.8 years. A repetitive ventricular response (V(3)) was observed at a critical coupling interval of prematurity in 10 of 22 children (45%). This response was similar in morphology and axis orientation to the premature and paced beats and was preceded by a His bundle depolarization. The V(3) response occurred nearly as frequently in patients without ventricular dysrhythmias as in those with ventricular dysrhythmias. The V(3) response is a normal phenomenon during ventricular stimulation.
