Abstract
Benign ventricular tachycardia (VT) in children usually arises from the right ventricle. By contrast, the implications of idiopathic left ventricular tachycardia (LVT) in children have not been examined. Between September 1981 and September 1986 we identified 28 children with VT who had no physical, ECG or x-ray evidence of underlying heart disease. Eight of these (28%) had VT localized to the LV and are the basis of this report. Age at presentation ranged from 0.8-14.8 years (median 1.3 years). All 8 had symptoms (heart failure 4/8, syncope 3/8, chest pain 2/8). Initial echocardiogram was nonspecific (reduced function 3/8, increased LV trabeculation 1/8). Cardiac catheterization pressures were normal in all 8, with angiographic evidence of posterobasal aneurysm in 2/8 and increased LV trabeculation in 1/8. Cardiac biopsy was abnormal in only 2/5. Electrophysiologic study (EPS) localized VT to the LV in all 8. VT was spontaneous in 4/8, inducible in 4/8, and sustained in all 8. Trials of an average 5.1 drugs/patient led to successful treatment in 6/8. Two others had a successful surgical cure.
We conclude that anglography, biopsy and EPS may reveal subtle causes of “idiopathic” LVT. Unlike right VT, LVT is usually symptomatic. In all cases of LVT, treatment is warranted, and a successful outcome achievable.
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Koike, K., Hesslein, P., Finlay, C. et al. “IDIOPATHIC” LEFT VENTRICULAR TACHYCARDIA IN CHILDREN: CHARACTERIZATION AND TREATMENT. Pediatr Res 21 (Suppl 4), 191 (1987). https://doi.org/10.1203/00006450-198704010-00148
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DOI: https://doi.org/10.1203/00006450-198704010-00148