Long-Term Course and Clinical Characteristics of Ventricular Tachycardia Detected in Children by School-Based Heart Disease Screening

Abstract

he incidence of ventricular tachycardia (VT) in childhood is low (0.2-0.8 per 10,000 children in school-based heart screening) compared with that in adults [1][2][3][4][5][6] in whom most VT is associated with coronary artery disease. In contrast, most pediatric cases are idiopathic without underlying heart disease and are found incidentally during school-based heart screening, with the exception of those found as complications of congenital heart diseases. The aim of the present study was to review the clinical picture and long-term course of patients in whom VT was detected by school-based screening. Methods SubjectsThe subjects were 48 children (23 males, 25 females) diagnosed with VT after routine school-based heart examinations conducted before they entered school or while they attended primary, junior or senior high school. All children undergo a 12-lead ECG, which pediatric cardiologists or Circulation Journal Vol.69, March 2005 pediatricians then check for abnormalities (the rate of abnormal ECGs is approximately 2-3% per annum). Children who have an abnormal ECG and have not been previously followed for heart disease, have a more detailed examination at a regional hospital. The present subjects were detected in this way and referred to the Department of Paediatrics, Yokohama City University Hospital where they were diagnosed as having VT. Of the 48 patients, underlying heart disease was detected in 2 cases (nonischemic left ventricular aneurysm, 1; arrhythmogenic right ventricular cardiomyopathy, 1), either at the time of the first medical examination after school-based screening or during follow-up. All of the 48 patients were followed for more than 2 years (2-30 years; average: 6 years) after the medical examinations. At the first medical examination, these subjects ranged in age from 5 to 15 years (average: 11 years). Cardiac ExaminationsAll subjects underwent an examination consisting of a 12-lead ECG, treadmill exercise test, chest X-ray and echocardiography to determine the presence or absence of underlying heart disease. The site of origin and type of VT (monomorphic or polymorphic) were determined on the basis of the QRS morphology of the VT detected by 12-lead ECG. Holter monitoring was used to record the (1) total number of premature ventricular contractions (PVC) in 1 day, (2) number of episodes of VT/day, the maximum number of salvos of VT and the heart rate during VT. Treadmill exercise stress testing and 24-h ECG monitoring Long-Term Course and Clinical Characteristics of Ventricular Tachycardia Detected in Children by School-Based Heart Disease ScreeningMari Iwamoto, MD; Ichiroh Niimura, MD † ; Toshimitsu Shibata, MD † † ; Kiyoshi Yasui, MD*; Kiyohiro Takigiku, MD**; Takashi Nishizawa, MD*; Tohru Akaike, MD; Shunpei Yokota, MD** Background The prognosis of ventricular tachycardia (VT) in children with overt heart disease is generally good, so the aim of this study was to review the prognosis and necessity of treatment of VT that detected by school-based heart disease screening. Method...

2015 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death

“…Zapadalność na utrwalony VT w ogólnej populacji pediatrycznej oceniono na 1/100 000 w ciągu 10 lat. Częstość występowania nieutrwalonego i utrwalonego VT również jest mała i wynosi 2-8/100 000 dzieci w wieku szkolnym [482,483].…”

Clinical Spectrum and Prognostic Factors of Pediatric Ventricular Tachycardia

“…Nonsustained IVT originated mainly from the RV rather than the LV (P=0.001), which is consistent with an earlier study. 12 In the present study, 27% of IVT patients had nonsustained VT, which was different from school-based heart disease screening in Japan, describing that 90% in healthy children diagnosed as VT had nonsustained VT. 13 It is because our data was from a single tertiary hospital where most patients were referred from other hospitals and many of them had symptoms.…”

Association of Human SCN5A Polymorphisms With Idiopathic Ventricular Arrhythmia in a Chinese Han Cohort

“…19,20 This case-control study investigated the association between IVA and SCN5A SNPs, in which overall 11 genetic variations including 5 novel and 6 previously identified ones were detected in 31 unrelated Chinese patients with IVA and 103 healthy controls. The study showed significant difference in distribution of c.87G>A and c.1673A>G between men and women in healthy subjects.…”