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Diagnosis-specific characteristics of ventricular tachycardia in children with structurally normal hearts

Samuel Wang1, Wei Zhu, Robert M Hamilton

  • 1Cardiology Division, The Hospital for Sick Children, Toronto, Ontario, Canada.

Heart Rhythm
|August 10, 2010
PubMed

Insights

Ventricular tachycardia (VT) in children with normal hearts varies by type. Left ventricular tachycardia (LVT) and catecholamine-sensitive polymorphic VT (CPVT) carry higher risks than accelerated idioventricular rhythm (AIVR) or right ventricular tachycardia (RVT).

Area of Science:

  • Pediatric Cardiology
  • Electrophysiology
  • Cardiovascular Medicine

Background:

  • Advancements in diagnostics refine ventricular tachycardia (VT) classification in children with structurally normal hearts.
  • Understanding VT subtypes is crucial for accurate prognosis and effective management in pediatric patients.

Purpose of the Study:

  • To analyze the clinical features and outcomes of children with VT using current diagnostic standards.
  • To stratify risk and guide treatment for pediatric VT based on specific diagnoses.

Main Methods:

  • Retrospective review of 77 patients under 18 years diagnosed with VT (1980-2005).
  • Exclusion of patients with systemic illness or underlying heart disease.
  • Categorization into accelerated idioventricular rhythm (AIVR), right ventricular tachycardia (RVT), left ventricular tachycardia (LVT), and catecholamine-sensitive polymorphic VT (CPVT).

Main Results:

  • AIVR patients were youngest with the mildest outcomes; CPVT patients had the most severe outcomes.
  • Ablation success rates were 50% for RVT and 80% for LVT.
  • Severe cardiac events occurred in 3/23 LVT patients and 2/5 CPVT patients (one death).

Conclusions:

  • VT management and prognosis in children with healthy hearts depend heavily on the specific VT diagnosis.
  • LVT and CPVT present significantly higher risks of morbidity and mortality compared to AIVR and RVT.
Abstract

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