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Left ventricular dysfunction is associated with frequent premature ventricular complexes and asymptomatic ventricular

R A Bertels1,2, L M Harteveld1,2, L H Filippini1,3

  • 1The Center for Congenital Heart Disease Amsterdam-Leiden, Leiden, 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
|April 22, 2017
PubMed

Insights

In children with frequent premature ventricular contractions (PVCs) and ventricular tachycardias (VTs), high PVC burden and sustained VTs are risk factors for left ventricular (LV) dysfunction. LV dysfunction is reversible with treatment.

Area of Science:

  • Pediatric Cardiology
  • Electrophysiology
  • Cardiovascular Imaging

Background:

  • Idiopathic frequent premature ventricular contractions (PVCs) and asymptomatic ventricular tachycardias (VTs) are increasingly diagnosed in children.
  • Left ventricular (LV) dysfunction can be a serious complication, but risk factors in this population are not well-defined.

Purpose of the Study:

  • To identify risk factors associated with the development of left ventricular (LV) dysfunction in pediatric patients with frequent premature ventricular contractions (PVCs) and asymptomatic ventricular tachycardias (VTs).

Main Methods:

  • Retrospective evaluation of 72 pediatric patients diagnosed with frequent PVCs (≥5% on 24h Holter) and asymptomatic VTs.
  • LV dysfunction defined as a shortening fraction ≤28%.
  • Comparison of clinical and electrophysiological characteristics between patients with and without LV dysfunction.

Main Results:

  • Six patients (8%) developed LV dysfunction, with a higher PVC burden (47% vs. 16%), higher prevalence of VT (83% vs. 41%), sustained VT (50% vs. 6%), and couplets (100% vs. 52%).
  • Patients with LV dysfunction were older (10 vs. 8 years) but symptom prevalence was similar (33% in both groups).
  • LV function normalized in 5/6 patients after treatment with medication or ablation.

Conclusions:

  • Higher PVC burden, presence of sustained ventricular tachycardia (sVT), and couplets are significant risk factors for developing left ventricular (LV) dysfunction in children with frequent PVCs and asymptomatic VTs.
  • Left ventricular (LV) dysfunction in this cohort appears to be reversible with interventions aimed at reducing the PVC burden.
Abstract

Keywords:
Asymptomatic ventricular tachycardiaChildrenLeft ventricular dysfunctionPremature ventricular complexes

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