High burden of premature ventricular contractions in structurally normal hearts: To worry or not in pediatric patients?
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Updated: Jan 23, 2026
Patient-specific Modeling of the Heart: Estimation of Ventricular Fiber Orientations
Published on: January 8, 2013
Nandita Sharma1,2, Daniel Cortez2,3,4, Jason R Imundo1
1Division of Pediatric Cardiology, Department of Pediatrics, Penn State Children's Hospital, Hershey, Pennsylvania.
Insights
Frequent premature ventricular contractions (PVCs) in children with healthy hearts typically resolve on their own and do not impact left ventricular function. This study found PVC burden decreased over time without intervention.
Area of Science:
- Pediatric Cardiology
- Electrophysiology
- Cardiovascular Health
Background:
- Limited data exists on the significance of high premature ventricular contractions (PVCs) in healthy children.
- The impact of frequent PVCs on left ventricular (LV) function and arrhythmia risk requires further investigation.
Purpose of the Study:
- To assess the prevalence of LV systolic dysfunction in children with frequent PVCs.
- To determine if PVC characteristics predict LV dysfunction in pediatric patients.
Main Methods:
- A retrospective review of 134 children (6 months-21 years) with frequent PVCs identified via 24-hour Holter monitoring.
- Patients were categorized by PVC burden: >10%, 10%-20%, and >20%.
- Analysis focused on PVC-induced cardiomyopathy and the natural history of PVC burden.
Main Results:
- The median PVC burden was 8.7% with a median follow-up of 2.8 years.
- In patients without intervention, PVC burden decreased by 67% from baseline.
- No deaths were reported during the follow-up period.
Conclusions:
- Premature ventricular contractions in children with structurally normal hearts generally follow a benign course.
- There is a trend towards spontaneous resolution of frequent PVCs in this pediatric population.
Background:
There is paucity of data regarding the significance of high percentage of premature ventricular contractions (PVCs) in healthy children and their impact on left ventricular (LV) function and the risk of ventricular arrhythmias. The purpose of this study was to assess the prevalence of LV systolic dysfunction in children with frequent PVCs and determine whether PVC characteristics were predictive of LV dysfunction.
Methods:
We performed a single-center retrospective review to examine the prevalence of PVC-induced cardiomyopathy and natural history of PVC burden in children with frequent PVCs. Children aged 6 months-21 years with PVCs noted on 24-hr Holter monitoring studies were enrolled. The four categories included those with a PVC burden of >10%, 10%-20%, and those with more than 20% PVC burden.
Results:
A total of 134 children were included, 65 with more than 10% PVCs and 31 with more than 20% PVCs. Median age of the patients was 10.5 years (IQR 6.1-14.8 years), with 79 males (54.5%). Median PVC burden was 8.7% (IQR 4.2%-16.9%) with median follow-up of 2.8 years (IQR 1.2-4.6 years). During 2.8 years (1.3-4.3 years) of follow-up, the PVC burden decreased by 67% of baseline PVC burden in those who did not undergo any intervention. There were no deaths.
Conclusion:
PVCs in children with structurally normal hearts are associated with a relatively benign course, with trend toward spontaneous resolution.
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