BACKGROUND: Isolated monomorphic premature ventricular contractions (PVCs) are not uncommon in the pediatric population. The degree of cardiac dysfunction caused by PVCs in children without structural heart disease is unknown. PURPOSE: To investigate the influence of PVCs on echocardiographic left ventricular (LV) systolic function in children without structural heart disease. METHODS: Forty asymptomatic children with isolated monomorphic PVCs without structural heart disease were selected. The median age was 6 years, range of 3-12 years. The following subgroups were compared: frequent vs. infrequent PVCs (> or < or = 10/min); short vs. long coupling interval (RR'/RR ratio < or = or > 0.6); and short vs. long QT interval (QT < or = or > 400 ms). Using echocardiography the left ventricular ejection fraction (LVEF in percentage) and cardiac index (CI in L/min/m2) were measured for both normal sinus beats (SB-LVEF and CI), PVCs (PVC-LVEF and CI) and the average LVEF and CI were calculated. All values were expressed as means +/- SD. RESULTS: In all children LV dimensions and the SB-LVEF and CI were within normal limits. The PVC-LVEF (48 +/- 5) and PVC-CI (1.57 +/- 0.19) were significantly decreased and the average CI was 2.41 +/- 0.29. In 27 pts with > 10 PVCs/min the average LVEF and CI decreased to 53 +/- 5 and 2.08 +/- 0.24 respectively. In 16 pts with PVCs and a short coupling interval (RR'/RR < or = 0.6) the PVC-LVEF and PVC-CI was 43 +/- 0.03 and 1.50 +/- 0.14, which was significantly lower than in 24 pts with a long coupling interval (58 +/- 4, 1.88 +/- 0.11). In 11 pts with a prolonged QT interval (> 400 ms) the PVC-LVEF and PVC-CI was significantly lower than in the 29 children with a shorter QT interval, 41 +/- 5 vs. 55 +/- 4 and 1.46 +/- 0.13 vs. 1.86 +/- 0.15 respectively (all p < 0.01). CONCLUSION: In asymptomatic children with isolated monomorphic PVCs the average ejection fraction and cardiac output is markedly reduced if PVCs are frequent (> 10/min), have a short coupling interval or a prolonged QT interval.
BACKGROUND: Isolated monomorphic premature ventricular contractions (PVCs) are not uncommon in the pediatric population. The degree of cardiac dysfunction caused by PVCs in children without structural heart disease is unknown. PURPOSE: To investigate the influence of PVCs on echocardiographic left ventricular (LV) systolic function in children without structural heart disease. METHODS: Forty asymptomatic children with isolated monomorphic PVCs without structural heart disease were selected. The median age was 6 years, range of 3-12 years. The following subgroups were compared: frequent vs. infrequent PVCs (> or < or = 10/min); short vs. long coupling interval (RR'/RR ratio < or = or > 0.6); and short vs. long QT interval (QT < or = or > 400 ms). Using echocardiography the left ventricular ejection fraction (LVEF in percentage) and cardiac index (CI in L/min/m2) were measured for both normal sinus beats (SB-LVEF and CI), PVCs (PVC-LVEF and CI) and the average LVEF and CI were calculated. All values were expressed as means +/- SD. RESULTS: In all children LV dimensions and the SB-LVEF and CI were within normal limits. The PVC-LVEF (48 +/- 5) and PVC-CI (1.57 +/- 0.19) were significantly decreased and the average CI was 2.41 +/- 0.29. In 27 pts with > 10 PVCs/min the average LVEF and CI decreased to 53 +/- 5 and 2.08 +/- 0.24 respectively. In 16 pts with PVCs and a short coupling interval (RR'/RR < or = 0.6) the PVC-LVEF and PVC-CI was 43 +/- 0.03 and 1.50 +/- 0.14, which was significantly lower than in 24 pts with a long coupling interval (58 +/- 4, 1.88 +/- 0.11). In 11 pts with a prolonged QT interval (> 400 ms) the PVC-LVEF and PVC-CI was significantly lower than in the 29 children with a shorter QT interval, 41 +/- 5 vs. 55 +/- 4 and 1.46 +/- 0.13 vs. 1.86 +/- 0.15 respectively (all p < 0.01). CONCLUSION: In asymptomatic children with isolated monomorphic PVCs the average ejection fraction and cardiac output is markedly reduced if PVCs are frequent (> 10/min), have a short coupling interval or a prolonged QT interval.
Authors: Jonathan Potfay; Karoly Kaszala; Alex Y Tan; Adam P Sima; John Gorcsan; Kenneth A Ellenbogen; Jose F Huizar Journal: Circ Arrhythm Electrophysiol Date: 2015-08-21
Authors: Francisco Contijoch; Kelly Rogers; Hannah Rears; Mohammed Shahid; Peter Kellman; Joseph Gorman; Robert C Gorman; Paul Yushkevich; Erica S Zado; Gregory E Supple; Francis E Marchlinski; Walter R T Witschey; Yuchi Han Journal: Circ Arrhythm Electrophysiol Date: 2016-04