Related Experiment Videos
Recurrent ventricular tachycardia in asymptomatic young children with an apparently normal heart
J P Pfammatter1, T Paul, H C Kallfelz
1Department of Paediatric Cardiology, Children's Hospital, Hannover Medical School, Germany.
Insights
Asymptomatic ventricular tachycardia in children with normal hearts is rare but carries a good prognosis. Close monitoring is recommended over invasive procedures or antiarrhythmic drugs for these young patients.
Area of Science:
- Pediatric Cardiology
- Electrophysiology
Background:
- Ventricular tachycardia (VT) is uncommon in infants and children without diagnosed heart conditions.
- This study focuses on recurrent, asymptomatic, and self-limiting VT in young children.
Observation:
- Four children (median age 8 months) presented with frequent VT episodes.
- Noninvasive investigations revealed no underlying heart disease in any patient.
- Most children received antiarrhythmic drugs initially, but treatment was often discontinued due to lack of symptoms or efficacy.
Findings:
- All patients remained asymptomatic despite recurrent VT episodes after a mean follow-up of 32 months.
- Antiarrhythmic drugs showed limited efficacy in suppressing VT in this cohort.
- One child continued beta-blocker therapy, while another received no antiarrhythmic treatment.
Implications:
- Asymptomatic pediatric VT with a normal heart has a favorable prognosis.
- Invasive procedures like electrophysiological studies can be deferred in asymptomatic cases.
- Observation without antiarrhythmic therapy may be a viable strategy for these patients, necessitating close follow-up.
Unlabelled:
Ventricular tachycardia without underlying heart disease is rare in infancy and childhood. Four young children (median age 8 months at initial presentation) with frequently recurrent episodes of asymptomatic and self-limiting ventricular tachycardia are reported. By noninvasive investigation no apparent heart disease has been found in all patients. Initially three of the four children had been treated with an anti-arrhythmic drug. Treatment was soon stopped in two patients for lack of symptoms and for lack of efficacy of therapy; one patient remained on beta-blocker therapy. One child did not receive anti-arrhythmic therapy. After a mean follow up of 32 months all patients continued to be asymptomatic despite frequently recurrent episodes of self-limiting ventricular tachycardia.
Conclusion:
Ventricular tachycardia in asymptomatic children with an otherwise normal heart carries a good prognosis. Invasive investigation (cardiac catheterization with electrophysiological study and right ventricular biopsy) can be withhold, as long as there are no symptoms. For lack of efficiency of antiarrhythmic drugs in suppressing ventricular tachycardia in asymptomatic children with apparently normal hearts, these patients may be left without therapy but have to be followed closely.