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Natural history of ventricular premature contractions in children with a structurally normal heart: does origin

Gertie C M Beaufort-Krol1, Sebastiaan S P Dijkstra, Margreet Th E Bink-Boelkens

  • 1Division of Pediatric Cardiology, Beatrix Children's Hospital, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.

Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology
|May 8, 2008
PubMed

Insights

Premature ventricular contractions (PVCs) originating from the right ventricle (PVC-RBBB) typically resolve in childhood, suggesting no need for follow-up. However, left ventricular PVCs (PVC-LBBB) persist, potentially requiring lifelong monitoring.

Area of Science:

  • Pediatric Cardiology
  • Electrophysiology
  • Cardiac Arrhythmias

Background:

  • Premature ventricular contractions (PVCs) are common in children and often considered benign, particularly if they resolve with exercise.
  • The natural history and prognostic implications of PVCs in children with structurally normal hearts require further elucidation.
  • Distinguishing between PVCs originating from the right ventricle (PVC-RBBB) and left ventricle (PVC-LBBB) may be crucial for management.

Purpose of the Study:

  • To investigate the natural history of frequent premature ventricular contractions (PVCs) in children with anatomically normal hearts.
  • To determine if there are differences in the long-term outcomes of PVCs based on their origin (left vs. right ventricle).

Main Methods:

  • A cohort of 59 children with frequent PVCs and normal cardiac anatomy was evaluated.
  • Diagnostic tools included 12-lead ECG, echocardiography, Holter monitoring, and exercise testing.
  • Children were followed for an average of 3.1 years, with multiple evaluations.

Main Results:

  • Premature ventricular contraction with left bundle branch block (PVC-LBBB) occurred in 41% of patients, PVC-RBBB in 36%, and 23% were undetermined.
  • Overall PVC burden decreased with age, but this trend was not statistically significant (P=0.08).
  • PVC-RBBB significantly decreased over time (P < 0.02), while PVC-LBBB showed no significant change.

Conclusions:

  • There is a distinct natural history for PVC-LBBB and PVC-RBBB in children with normal hearts.
  • PVC-RBBB generally resolves during childhood, and routine follow-up may not be necessary.
  • PVC-LBBB persists into adulthood, indicating a potential need for ongoing monitoring.
Abstract

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