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HomePediatrics: Cardiac Disease and Critical Care MedicinePediatric Ventricular Tachycardia Overview of Ventricular Arrhythmias

Pediatric Ventricular Tachycardia Overview of Ventricular Arrhythmias

Overview of Ventricular Arrhythmias

Ventricular arrhythmia (VA) may be an isolated and completely benign finding in children, a marker of serious systemic disease or myopathy, or a mechanism for syncope and sudden cardiac death (SCD). 

Isolated premature ventricular contractions (PVCs) are reasonably common. They occur with low daily frequency in as many as 40% of persons with apparently normal hearts.
PVCs occur with increased frequency in more than 60% of patients with some types of repaired congenital heart disease (CHD).

By comparison, sustained VA is much less frequent. Although sustained VA can occur in apparently normal hearts, approximately 50% of patients have either CHD or myopathy. An increasingly sophisticated molecular understanding of the role of electrical myopathies, including ion-channel defects such as long QT syndrome (LQTS), offers increased insight into the nature of some of these diseases.

Clinical choices regarding imaging and therapy primarily focus on the potential mortality risks associated with the specific clinical setting. The incidence of SCD in pediatric patients is low. Even among patients with known heart disease, clinical decisions are challenging because of the potential risks of potent antiarrhythmic medications and of nonpharmacologic therapy (eg, catheter ablation, implantable antitachycardia pacemakers and/or defibrillators).

The prognosis cannot be generalized; it must be individualized and based on the underlying diagnosis.

Go to Ventricular Tachycardia for complete information on this topic.

Patient education

Patients with VA and their families must know how to perform cardiopulmonary resuscitation (CPR) and how to contact local emergency medical services (EMS) to promptly begin therapy or prevent excessive therapy, as warranted. Not all patients need a home ambulatory external defibrillator (AED).

For patient education information, see the Heart Center, as well as Tetralogy of Fallot.

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