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Postinfarction ventricular arrhythmias in children
C L Johnsrude1, J A Towbin, F Cecchin
1Division of Pediatric Cardiology, Baylor College of Medicine, Houston, TX 77030, USA.
Insights
Ventricular tachycardia or fibrillation is common in children after myocardial infarction, leading to high mortality. Survivors, however, showed no significant recurrent arrhythmias or late sudden death.
Area of Science:
- Pediatric Cardiology
- Cardiovascular Research
- Clinical Pediatrics
Background:
- Limited data exists on significant arrhythmias following myocardial infarction in pediatric patients.
- Understanding post-infarction arrhythmias is crucial for managing pediatric cardiac events.
Purpose of the Study:
- To determine the incidence and impact of ventricular tachycardia or fibrillation (VT/VF) in children (1 day to 16 years) after myocardial infarction.
- To analyze the association of VT/VF with mortality and long-term outcomes in this population.
Main Methods:
- Retrospective review of 96 pediatric patients diagnosed with myocardial infarction.
- Analysis of patient data including underlying heart disease, occurrence of VT/VF, mortality, and long-term follow-up.
Main Results:
- Ventricular tachycardia/fibrillation occurred in 28% of pediatric acute myocardial infarction cases, often within 2 days.
- Post-infarction mortality was high (61%) in acute myocardial infarction patients, irrespective of underlying heart disease.
- VT/VF was linked to approximately 80% mortality in patients with acute or remote myocardial infarction.
Conclusions:
- Ventricular tachycardia/fibrillation is a frequent and early complication of myocardial infarction in children.
- High mortality rates are associated with post-infarction VT/VF in pediatric patients.
- Pediatric myocardial infarction survivors without significant VT/VF experienced favorable long-term outcomes with no recurrent arrhythmias or sudden death.
Abstract:
Because limited information is available on significant arrhythmias after myocardial infarction in pediatric patients, this study was performed to determine the incidence and impact of ventricular tachycardia or fibrillation on the postinfarction course in patients aged 1 day to 16 years. Review of 96 such children showed a wide range of underlying heart disease (56 patients with congenital heart disease, 12 with cardiomyopathy, and 28 with acquired heart disease). Postinfarction ventricular tachycardia/fibrillation occurred commonly (28% of patients with acute myocardial infarction) and early (84% by 2 days after diagnosis). Postinfarction mortality was high in patients with acute myocardial infarction (61%) and appeared to be independent of type of associated heart disease. Ventricular tachycardia/fibrillation was associated with higher mortality rates (approximately 80%) in patients with acute or remote myocardial infarction. The 61 postinfarction survivors were monitored for an average of 4.9 years, and none had significant recurrent ventricular arrhythmias or late sudden death.