Frequent Ventricular Premature Beats in Children With a Structurally Normal Heart: A Cause for Reversible Left Ventricular Dysfunction? |
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Authors: | Bahram Kakavand Hubert O Ballard Thomas G Disessa |
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Institution: | (1) Department of Pediatrics, Division of Cardiology, University of Kentucky, 800 Rose Avenue, MN150, Lexington, KY 40536-0298, USA;(2) Department of Pediatrics, Division of Neonatology, University of Kentucky, 800 Rose Avenue, MN150, Lexington, KY 40536-0298, USA |
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Abstract: | Ventricular premature beats (VPBs) in a structurally normal heart generally are a benign condition. Rarely, however, reversible
cardiomyopathy may develop. This study aimed to evaluate the incidence of cardiomyopathy among pediatric patients in a cohort
with frequent VPBs and to examine the characteristics of the ventricular ectopic beats as well as therapeutic options. This
study reviewed the charts of all pediatric patients between the ages of 1 day and 18 years seen at the University of Kentucky
with the diagnosis of VPBs between 2003 and 2007. Frequent VPBs were defined as an ectopy burden of 5% or more in 24 h. Electrocardiograms,
Holter monitors, and echocardiograms were reviewed. The review identified 28 patients (17 boys, age 13.3 ± 5.9 years, and
11 girls, age 13 ± 5.2 years) with frequent VPBs. The echocardiograms of four patients (2 boys, 14%) showed cardiomyopathy.
Cardiac function normalized in all four patients, with spontaneous resolution of the VPBs (2 patients) or with antiarrhythmic
therapy (2 patients). During a follow-up period of 2.7 ± 2.3 years, 32% of the patients without cardiomyopathy showed a marked
spontaneous improvement in arrhythmia burden. Most of the patients showed VPBs with a left bundle branch block (LBBB) and
inferior axis morphology. The most commonly associated symptoms were chest pain (17.8%) and dizziness and syncope (21.4%).
Generally, VPBs in structurally normal hearts are considered benign. Rarely, a reversible cardiomyopathy can develop, requiring
therapeutic intervention. |
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