Among children with a high premature ventricular contraction burden (≥20%), 19.4% (95% CI 6.2-32.6%) met criteria for cardiomyopathy, mostly at initial presentation.
Observational (n=36)
No
What is the prevalence of premature ventricular contraction-induced cardiomyopathy in children with frequent premature ventricular contractions?
Children with a high burden of premature ventricular contractions have a nearly 20% prevalence of PVC-induced cardiomyopathy, highlighting the need for regular imaging follow-up.
BACKGROUND: Adults with high premature ventricular contraction burden can develop left ventricular dilation, dysfunction, and strain, consistent with a cardiomyopathy, which is reversible with radiofrequency ablation of the premature ventricular contractions. Evidence in children with similar ectopy burden is limited. We performed a single-centre retrospective review to examine the prevalence of premature ventricular contraction-induced cardiomyopathy, natural history of ventricular ectopy, and progression to ventricular tachycardia in children with frequent premature ventricular contractions. METHODS: Children aged between 6 months and 18 years, with premature ventricular contractions comprising at least 20% of rhythm on 24-hour Holter monitor, were included in our study. Those with significant structural heart disease, ventricular tachycardia greater than 1% of rhythm at the time of premature ventricular contraction diagnosis, or family history of cardiomyopathy - except tachycardia-induced - were excluded. Cardiomyopathy was defined by echocardiographic assessment. RESULTS: A total of 36 children met the study criteria; seven patients (19.4%, 95% CI 6.2-32.6%) met the criteria for cardiomyopathy, mostly at initial presentation. Ectopy decreased to <10% of beats without intervention in 16.7% (95% CI 4.3-29.1%) of the patients. No patient progressed to having ventricular tachycardia as more than 1% of beats on follow-up Holter. Radiofrequency ablation was performed in three patients without cardiomyopathy. CONCLUSIONS: Our study demonstrates a higher prevalence of cardiomyopathy among children with high premature ventricular contraction burden than that previously shown. Ectopy tended to persist throughout follow-up. These trends suggest the need for a multi-centre study on frequent premature ventricular contractions in children. In the interim, regular follow-up with imaging to evaluate for cardiomyopathy is warranted.
Spector et al. (Wed,) conducted a observational in Frequent premature ventricular contractions (n=36). High premature ventricular contraction burden (≥20%) was evaluated on Prevalence of cardiomyopathy (95% CI 6.2-32.6). Among children with a high premature ventricular contraction burden (≥20%), 19.4% (95% CI 6.2-32.6%) met criteria for cardiomyopathy, mostly at initial presentation.