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Frequent Ventricular Premature Beats in Children and Adolescents: Natural History and Relationship with Sport Activity in a Long-Term Follow-Up

  • Giulio PorceddaEmail author
  • Alice Brambilla
  • Silvia Favilli
  • Gaia Spaziani
  • Giuseppe Mascia
  • Marzia Giaccardi
Original Article
  • 78 Downloads

Abstract

Premature ventricular complexes (PVCs) are frequently documented in children. To date, few studies report long-term follow-up in pediatric cohorts presenting with frequent PVCs. The aim of this study is to assess the clinical relevance and long-term outcomes of frequent PVCs (≥ 500/24 h) in a large pediatric cohort. From 1996 to 2016, we enrolled all consecutive patients evaluated at Anna Meyer Children Hospital for frequent PVCs. Symptomatic children were excluded together with those patients with known underlying heart diseases; thus, our final cohort of study included 103 patients (male 66%; mean age 11 ± 3.4 years), with a mean follow-up of 9.5 ± 5.5 years. All patients were submitted to complete non-invasive cardiologic evaluation. The mean number of PVCs at Holter Monitoring (HM) was 11,479 ± 13,147/24 h; couplets and/or triplets were observed in 5/103 (4.8%) cases; 3 patients (2.9%) presented runs of non-sustained ventricular tachycardia (NSVT). High-burden PVCs (> 30,000/24 h) was confirmed in 11/103 (10.6%) patients. During the follow-up, only five patients (4.8%) developed clinical symptoms (3 for palpitations, 1 myocardial dysfunction due to frequent PVCs and NTSV; 1 arrhythmogenic cardiomyopathy); no deaths occurred. Basal PVCs were still present in 45/103 (43.7%) patients. Our data suggest that frequent PVCs may be addressed as a benign condition and should not preclude sport participation if not associated with cardiac malformations, heart dysfunction, or cardiomyopathy. This seems to be true also in presence of very frequent/high-burden PVCs. Otherwise, a careful follow-up is mandatory since sport eligibility should be reconsidered in case of onset of symptoms and/or ECG/echocardiographic changes.

Keywords

Premature ventricular contractions Screening Children Ventricular tachicardia 

Abbreviations

Pts

Patients

PVCs

Premature ventricular complexes

ECG

Electrocardiogram/electrocardiographic/electrocardiography

Echo

Doppler echocardiography

ET

Effort test/stress test

HM

Holter monitoring

MRI

Magnetic resonance imaging

EPS

Electrophysiologic study

RV

Right ventricle

RVOT

Right ventricular outflow tract

RBBB

Right bundle branch block

LBBB

Left bundle branch block

NSVT

Non-sustained ventricular tachycardia

VAs

Ventricular arrhythmias

LV

Left ventricle

Notes

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

The research involves human participants and informed consent forms have been collected from all patients or their parents. The present study was conducted according with the 1964 Helsinki declaration and its later amendments.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Giulio Porcedda
    • 1
    Email author
  • Alice Brambilla
    • 1
  • Silvia Favilli
    • 1
  • Gaia Spaziani
    • 1
  • Giuseppe Mascia
    • 2
  • Marzia Giaccardi
    • 2
  1. 1.Pediatric Cardiology UnitA. Meyer HospitalFlorenceItaly
  2. 2.Cardiology and Electrophysiology UnitS. M. Nuova HospitalFlorenceItaly

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