Analysis of Morphological Characteristics and Origins of Idiopathic Premature Ventricular Contractions Under a 12-Lead Electrocardiogram in Children with Structurally Normal Hearts

Abstract

SummaryUp to 40% of healthy children have premature ventricular complexes or contractions (PVCs) detected with 24-hour Holter monitoring. We aimed to investigate the morphological characteristics and origins of idiopathic PVCs under a 12-lead electrocardiogram in children with structurally normal hearts. All asymptomatic monomorphic PVC patients with structurally normal hearts under 18 years of age were included in this retrospective study. Characteristics of PVCs in lead V1 under a 12-lead electrocardiogram were classified as left bundle branch block (PVC-LBBB) or right bundle branch block (PVC-RBBB). According to limb leads, PVC-LBBB or PVC-RBBB was divided into: PVCs-LBBB type I; PVCs-LBBB type II; PVCs-RBBB type I; PVCs-RBBB type II; and PVCs-RBBB type III. Out of 178 PVC patients, 94 cases of PVCs-LBBB (PVCs-LBBB type I = 60; PVCs-LBBB type II = 34) and 84 cases of PVCs-RBBB (PVCs-RBBB type I = 3; PVCs-RBBB type II = 55; PVCs-RBBB type III = 26) were identified. The frequency of PVCs-LBBB type I increased with age and the frequency of PVCs-RBBB type II and III decreased with age. Among the children monitor tested, from 1 years old to 18 years old, PVCs originating from the left or right ventricular outflow tract gradually increased with age, while PVCs originating from the branch sources decreased with age.(Int Heart J 2017; 58: 714-719)

Effect of Mobile Internet on Attitude and Self-Efficacy of Patients with Coronary Heart Disease Diagnosed by 12-Lead Holter ECG

“…However, in recent years, a number of related studies have shown that angina pectoris caused by myocardial ischemia may not present with ischemic ST changes. Meanwhile, according to the investigation, about 30% of patients with chronic angina pectoris are diagnosed as normal at rest by ECG, which shows that the routine ECG has certain limitations in the diagnosis of CHD, with high rate of clinical missed diagnosis [20][21][22]. 12-lead Holter ECG has the function of 24 h automatic monitoring and comprehensive visualization of patients' condition of myocardial ischemia and can also analyze the condition by 24 h graph, trend graph, full view graph, and heart rate change graph, more closely monitoring the patients' condition and progress.…”

Idiopathic Ventricular Arrhythmia Ablation Using Non-Fluoroscopic Catheter Visualization System

“…Based on the acquired i-PVC/VT ECG morphology and the activation timing from the diagnostic catheters, the initial chamber to be mapped was determined. 12) For mapping and ablation, an 8-Fr sheath was introduced, via the right femoral vein or the femoral artery, and a MediGuide-enabled, bi-directional, irrigated ablation catheter (MediGuide Enabled Safire Duo Catheter, Abbott) was advanced to the chamber of interest, in NFCV patients. For the index 13 procedures, right ventriculography (RVG) was performed before mapping and used as the background image ( Figure 1A, B).…”

Hemodynamic Effects of Premature Ventricular Contractions in Children

“…При левожелудочковой ЖЭС чаще выявлялись структурные аномалии миокарда (жировое замещение миокарда, отек, фиброз) по сравнению с пациентами с ЖЭС из правых отделов, что может ассоциироваться с худшим прогнозом заболевания [20]. Однако исследования, основанные на длительном наблюдении и ретроспективном анализе естественного течения ЖЭС у детей без структурных изменений сердца, показали, что ЖЭС из левых отделов с возрастом имеет тенденцию к уменьшению и самопроизвольному исчезновению [22,23].…”