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[Ventricular tachycardia in children]

R Grolleau1, P Messner, F Leclercq

  • 1Service de cardiologie, hôpital Arnaud-de-Villeneuve, Montpellier.

Archives Des Maladies Du Coeur Et Des Vaisseaux
|May 1, 1993
PubMed
Summary

Pediatric ventricular tachycardia (VT) differs from adults, often occurring without apparent heart disease. While some cases are benign, others require active treatment, with advancements in ablation and device therapies offering new hope.

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Area of Science:

  • Pediatric cardiology
  • Electrophysiology
  • Arrhythmology

Context:

  • Ventricular tachycardia (VT) in children presents unique challenges compared to adults, primarily due to the rarity of ischemic heart disease in this demographic.
  • VT can manifest with severe symptoms like cardiac failure or syncope and complicates outcomes in specific pediatric cardiac conditions such as Tetralogy of Fallot and arrhythmogenic right ventricular dysplasia.
  • While cardiomyopathies can cause VT, ventricular dysfunction may be secondary to the arrhythmia itself and reversible with treatment.

Purpose:

  • To delineate the distinct characteristics and etiologies of ventricular tachycardia in pediatric populations.
  • To review the diagnostic and therapeutic approaches for childhood VT, considering age-specific factors.
  • To highlight the evolving role of interventional procedures like ablation and the judicious use of devices in managing pediatric VT.

Summary:

  • Childhood ventricular tachycardia (VT) differs significantly from adult VT, with ischemic causes being rare. It can arise from structural heart disease, cardiomyopathies, or occur without identifiable cardiac pathology.
  • Prognosis varies, ranging from benign forms to those requiring aggressive management. Specific types like incessant tachycardia of the newborn and Torsades de Pointes have distinct features and management considerations.
  • Pharmacological agents like amiodarone and beta-blockers are mainstays, while diagnostic and therapeutic interventions, including ablation and device implantation, are increasingly utilized, with careful case-by-case evaluation.

Impact:

  • Improved understanding of pediatric VT pathophysiology and clinical presentation.
  • Guidance on appropriate diagnostic workup and risk stratification for children with VT.
  • Informed clinical decision-making regarding pharmacological, interventional, and device-based therapies for pediatric VT.

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