Special electrophysiological characteristics of pediatric idiopathic ventricular tachycardia
| Autor: | Shuenn-Nan Chiu, Wei-Lun Wu, Chun-Wei Lu, Ming-Tai Lin, Jou-Kou Wang, Mei-Hwan Wu, Wei-Chieh Tseng, Kun-Lang Wu, Chien-Chih Chang |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Cardiac function curve
Male medicine.medical_specialty Cardiac Catheterization Adolescent Radiofrequency ablation medicine.medical_treatment Cardiomyopathy Taiwan 030204 cardiovascular system & hematology Ventricular tachycardia law.invention Cohort Studies 03 medical and health sciences QRS complex Electrophysiology study Electrocardiography Young Adult 0302 clinical medicine law Heart Conduction System 030225 pediatrics Internal medicine medicine Humans cardiovascular diseases Child medicine.diagnostic_test business.industry Ablation medicine.disease Electrophysiological Phenomena Anesthesia Child Preschool Cardiology Tachycardia Ventricular Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | International journal of cardiology. 227 |
| ISSN: | 1874-1754 |
| Popis: | Idiopathic ventricular tachycardia (VT) is an important pediatric arrhythmia but relevant studies in Asian cohort are rare. We determined the electrophysiological characteristics and outcomes of this rhythm disturbance.From an institutional database, patients aged18years without structural heart disease who have sustained monomorphic VT (longer than 30s) during 1995-2016 were enrolled.We enrolled 57 idiopathic VT patients (male:female=31:26). The initial presentation included palpitation (64.9%) and shock (12.3%). The electrocardiography revealed relatively short QRS duration (123±18ms) and absence of ventriculoatrial dissociation in 33.3% of the patients, causing initial misdiagnosis in 29.8% of these patients. Patients with a VT onset age of10years were more likely to have a left bundle branch block morphology (52.2% vs. 11.8%, p=0.001) and spontaneous recovery than those with a VT onset age of ≥10years. An electrophysiology study in 44 patients revealed that the most common arrhythmia focus was the left ventricular septal area (78%), called fascicular VT. Radiofrequency ablation showed a satisfactory success rate (90%) and fair recurrence rate (14.3%). Tachycardia-induced cardiomyopathy was noted in 14% of the VT patients and cardiac function returned to normal in 1-18months (median, 3months) after successful ablation.In an Asian pediatric population, VT has distinct electrophysiological characteristics including dominant left ventricular origin, narrower QRS duration, and more symptomatic presentation. Transcatheter ablation is effective against VT, and the associated cardiomyopathy often resolves rapidly after successful ablation. |
| Databáze: | OpenAIRE |
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