Different response to vitamin D supplementation in children with RVOT morphology PVCs vs LV fascicular PVCs
Marius Bichescu1, Simona Sorana Cainap2, Cecilia Lazea3
15th Department of Internal Medicine, Cardiology Rehabilitation, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.
Insights
Vitamin D supplementation significantly reduced premature ventricular contractions (PVCs) in children with right ventricular outflow tract (RVOT) morphology. However, it did not show similar benefits for those with left fascicular PVCs, suggesting morphology-specific effects.
Area of Science:
- Cardiology
- Pediatrics
- Endocrinology
Background:
- Premature ventricular contractions (PVCs) are common arrhythmias, often benign in children with healthy hearts.
- Vitamin D deficiency is increasingly recognized as a potential contributing factor to cardiac arrhythmias, including PVCs.
- The specific impact of vitamin D supplementation on different types of pediatric PVCs, categorized by electrocardiogram morphology, requires further investigation.
Purpose of the Study:
- To investigate the efficacy of vitamin D supplementation in reducing the burden of PVCs in children with vitamin D deficiency.
- To compare the effects of vitamin D supplementation on PVCs between two distinct morphological groups: right ventricular outflow tract (RVOT) and left fascicular.
- To determine if baseline vitamin D levels correlate with PVC burden and response to supplementation.
Main Methods:
- A cohort of 46 children with increased PVC burden and vitamin D deficiency was enrolled.
- Patients were categorized into two groups based on PVC electrocardiogram morphology: RVOT (36 patients) and left fascicular (10 patients).
- Intervention involved oral vitamin D supplementation, with follow-up assessments of vitamin D levels and PVC burden.
Main Results:
- In the RVOT group, vitamin D levels increased significantly after supplementation, accompanied by an 80% reduction in PVC burden.
- In the left fascicular group, vitamin D levels also increased, but there was no significant change in PVC burden.
- These findings suggest a potential benefit of vitamin D supplementation specifically for children with RVOT PVCs.
Conclusions:
- Vitamin D supplementation appears effective in reducing PVC burden in children with vitamin D deficiency and RVOT PVCs.
- The lack of significant reduction in PVCs in the left fascicular group indicates that vitamin D's efficacy may be dependent on the underlying PVC morphology.
- Further research is warranted to elucidate the mechanisms and confirm these morphology-specific effects of vitamin D on pediatric arrhythmias.
Abstract:
Outflow tract premature ventricular contractions (PVCs) are typically benign arrhythmias in structurally normal hearts. Vitamin D insufficiency has been shown to cause PVCs in both children and adults. This study examined the impact of vitamin D supplementation in children with an increased burden of PVCs in 2 patient categories with distinct electrocardiogram morphologies: right ventricular outflow tract (RVOT) and left fascicular. We enrolled 46 patients (mean age 10.6 ± 4.1 years, 26% female) showing an increased burden of monomorphic PVCs (mean = 18,925/24 hours) and vitamin D deficiency. We compared 36 patients with RVOT morphology and 10 patients with left ventricular fascicular morphology. In the RVOT morphology group, the mean age was 12.7 ± 2.7 years, comprising 75% males and 25 females, with a PVC burden of 18,343.7 ± 13,836.2/24 hours and a 25-OH vitamin D level of 23.5 ± 9.4 ng/mL. After 2 months of oral vitamin D supplementation, the vitamin D level increased to 41.6 ± 6.3, followed by a considerable reduction in PVC burden to 3628.0 ± 2347.2. This group of children showed 80% reduction in PVC burden. In the left ventricular fascicular morphology group, the mean age was 6.9 ± 5.5 years, comprising 71% males and 29% females, with a PVC burden of 20,535.3 ± 20,867.9, and a vitamin D level of 25.8 ± 7.1 ng/mL. Following 3 months of oral vitamin D supplementation, vitamin D levels increased to 65.8 ± 42.8 ng/mL; however, there was no significant change in PVC burden (19,207.1 ± 22,807.8). Vitamin D supplementation may be effective in reducing PVC burden in children with vitamin D deficiency and RVOT PVCs.
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