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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.

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.

Authors+Show Affiliations

Pediatric Cardiology Unit, A. Meyer Hospital, Viale Pieraccini 24, 50139, Florence, Italy. giulio.porcedda@meyer.it.Pediatric Cardiology Unit, A. Meyer Hospital, Viale Pieraccini 24, 50139, Florence, Italy.Pediatric Cardiology Unit, A. Meyer Hospital, Viale Pieraccini 24, 50139, Florence, Italy.Pediatric Cardiology Unit, A. Meyer Hospital, Viale Pieraccini 24, 50139, Florence, Italy.Cardiology and Electrophysiology Unit, S. M. Nuova Hospital, Florence, Italy.Cardiology and Electrophysiology Unit, S. M. Nuova Hospital, Florence, Italy.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31712859

Citation

Porcedda, Giulio, et al. "Frequent Ventricular Premature Beats in Children and Adolescents: Natural History and Relationship With Sport Activity in a Long-Term Follow-Up." Pediatric Cardiology, 2019.
Porcedda G, Brambilla A, Favilli S, et al. Frequent Ventricular Premature Beats in Children and Adolescents: Natural History and Relationship with Sport Activity in a Long-Term Follow-Up. Pediatr Cardiol. 2019.
Porcedda, G., Brambilla, A., Favilli, S., Spaziani, G., Mascia, G., & Giaccardi, M. (2019). Frequent Ventricular Premature Beats in Children and Adolescents: Natural History and Relationship with Sport Activity in a Long-Term Follow-Up. Pediatric Cardiology, doi:10.1007/s00246-019-02233-w.
Porcedda G, et al. Frequent Ventricular Premature Beats in Children and Adolescents: Natural History and Relationship With Sport Activity in a Long-Term Follow-Up. Pediatr Cardiol. 2019 Nov 11; PubMed PMID: 31712859.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Frequent Ventricular Premature Beats in Children and Adolescents: Natural History and Relationship with Sport Activity in a Long-Term Follow-Up. AU - Porcedda,Giulio, AU - Brambilla,Alice, AU - Favilli,Silvia, AU - Spaziani,Gaia, AU - Mascia,Giuseppe, AU - Giaccardi,Marzia, Y1 - 2019/11/11/ PY - 2019/07/06/received PY - 2019/10/25/accepted PY - 2019/11/13/entrez KW - Children KW - Premature ventricular contractions KW - Screening KW - Ventricular tachicardia JF - Pediatric cardiology JO - Pediatr Cardiol N2 - 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. SN - 1432-1971 UR - https://www.unboundmedicine.com/medline/citation/31712859/Frequent_Ventricular_Premature_Beats_in_Children_and_Adolescents:_Natural_History_and_Relationship_with_Sport_Activity_in_a_Long-Term_Follow-Up L2 - https://dx.doi.org/10.1007/s00246-019-02233-w DB - PRIME DP - Unbound Medicine ER -