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High Burden Ventricular Ectopy > 10% in Children with Structurally Normal Hearts: Investigating the Association of

Julie Aldrich1,2, Zachary Daniels3, Mariah Eisner4

  • 1Department of Pediatrics, The Heart Center, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH, 43205, USA. julie.aldrich@nationwidechildrens.org.

Pediatric Cardiology
|November 12, 2024
PubMed

Insights

Ventricular dysfunction is uncommon in children with frequent ventricular ectopy (VE) and normal hearts. However, very frequent VE (>30%) and non-sustained ventricular tachycardia (NSVT) were linked to dysfunction.

Area of Science:

  • Pediatric Cardiology
  • Electrophysiology
  • Cardiac Imaging

Background:

  • Frequent ventricular ectopy (VE) in children with structurally normal hearts is not well-characterized.
  • The development of ventricular dysfunction in this population requires further description.

Purpose of the Study:

  • To describe frequent VE (≥10%) in children with structurally normal hearts.
  • To characterize the development of ventricular dysfunction in these children.

Main Methods:

  • Retrospective review of 234 children with VE burden ≥10% on 24-h Holter (2010-2019).
  • Exclusion of patients with pre-existing structural heart disease or cardiomyopathy.
  • Analysis of medical records, ECG, Holter, and echocardiogram data.
  • Classification based on VE burden (frequent 10-29%, very frequent ≥30%), presence of VE runs, morphology, coupling interval, and dysfunction development.

Main Results:

  • 17% (7) of patients developed ventricular dysfunction, mostly mild.
  • Very frequent VE (>30%) and non-sustained ventricular tachycardia (NSVT) were associated with dysfunction.
  • No association found between coupling interval or prematurity index and dysfunction.

Conclusions:

  • Ventricular dysfunction is uncommon in children with structurally normal hearts and frequent VE (>10%).
  • Higher VE burden (>30%) and NSVT are associated with dysfunction.
  • Traditional risk markers like coupling interval were not linked to dysfunction in this cohort.

Keywords:
HolterPediatricsPremature ventricular contractionVentricular dysfunctionVentricular ectopy

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