Journal of Child

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DOI :10.26650/jchild.2024.1588249   IUP :10.26650/jchild.2024.1588249    Full Text (PDF)

Evaluation of the Clinical Phenotype and Follow-up of Children with ‘Non sustained’ Ventricular Tachycardia Detected on 24-hour Rhythm Holter

Serra Karaca, Doruk Özbingöl, Kazım Öztarhan, Kemal Nişli

Objective: Non-sustained ventricular tachycardia (NSVT) is an important arrhythmic finding in pediatric patients, with varying clinical implications based on the presence of structural heart disease. This study aimed to evaluate the clinical characteristics, follow-up, and management of children diagnosed with NSVT detected on 24-hour Holter monitoring.

Methods: A retrospective analysis was conducted on 22 pediatric patients (9 males, 13 females) aged 2.5–17 years, who were diagnosed with NSVT between 2015 and 2023. Patients with sustained VT, channelopathies, or electrolyte-related prolonged QTc were excluded. Echocardiography, electrocardiography, and Holter monitoring were performed for all patients. Statistical analyses were conducted using SPSS 26.0, with significance set at p<0.05.

Results: Monomorphic NSVT was observed in 14 patients (64%), while polymorphic NSVT was found in 8 patients (36%). The mean VT rate was 161.2±18.7 bpm, with polymorphic VT demonstrating a significantly higher rate (175.3±4.4 bpm) than monomorphic VT (153.3±4.6 bpm) (p=0.003). The prematurity index was significantly lower in polymorphic VT (0.75±0.03) than in monomorphic VT (1.1±0.03) (p<0.001). Additionally, QTc was longer in polymorphic VT (463.5±5.1 ms vs. 425.4±6.5 ms, p=0.004). Structural heart disease was present in 50% of cases, with polymorphic VT being predominantly associated with cardiomyopathies (dilated, hypertrophic, and non-compaction). Only three patients (14%) were symptomatic, and all symptomatic patients had structural heart disease. All patients with underlying cardiac abnormalities were treated with beta-blockers, primarily propranolol, while those with normal echocardiography were followed without medication. No adverse effects, syncope, or mortality were observed during follow-up.

Conclusion: NSVT in pediatric patients should be carefully evaluated, particularly in the presence of structural heart disease. While monomorphic NSVT in structurally normal hearts appears benign, polymorphic NSVT is strongly associated with cardiomyopathies, necessitating medical therapy and close monitoring. Individualized management based on echocardiographic findings and arrhythmic characteristics is essential for optimizing patient outcomes.

Keywords: Non-sustained ventricular tachycardia, Holter monitoring, beta-blockers

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References

  • Whitaker J, Wright MJ, Tedrow U. Diagnosis and management of ventricular tachycardia. Clin Med (Lond). 2023;23(5):442-8. google scholar
  • Escudero CA, Tan RBM, Beach CM, Dalal AS, LaPage MJ, Hill AC. Approach to Wide Complex Tachycardia in Pediatric Patients. CJC Pediatr Congenit Heart Dis. 2022;1(2):60-73. google scholar
  • Kafalı HC, Ergül Y. Common Supraventricular and Ventricular Arrhythmias in Children. Turk Arch Pediatr. 2022;57(5):476-88. google scholar
  • Yabek SM. Ventricular arrhythmias in children with an apparently normal heart. J Pediatr. 1991;119(1 Pt 1):1-11. google scholar
  • Jacobsen JR, Garson A, Jr., Gillette PC, McNamara DG. Premature ventricular contractions in normal children. J Pediatr. 1978;92(1):36-8. google scholar
  • Paul T, Marchal C, Garson A, Jr. Ventricular couplets in the young: prognosis related to underlying substrate. Am Heart J. 1990;119(3 Pt 1):577-82. google scholar
  • Yusuf S, Lopez R, Sleight P. Heart rate and ectopic prematurity in relation to sustained ventricular arrhythmias. Br Heart J. 1980;44(3):233-9. google scholar
  • Garson A, Jr., Smith RT, Moak JP, Ross BA, McNamara DG. Ventricular arrhythmias and sudden death in children. J Am Coll Cardiol. 1985;5(6 Suppl):130b-3b. google scholar
  • Zeigler VL, Gillette PC, Crawford FA, Jr., Wiles HB, Fyfe DA. New approaches to treatment of incessant ventricular tachycardia in the very young. J Am Coll Cardiol. 1990;16(3):681-5. google scholar
  • Deal BJ, Miller SM, Scagliotti D, Prechel D, Gallastegui JL, Hariman RJ. Ventricular tachycardia in a young population without overt heart disease. Circulation. 1986;73(6):1111-8. google scholar
  • Rocchini, A. P., Chun, P. O., Dick, M. Ventricular tachycardia in children. Am J Cardiol. 1981;47(5):1091-7. google scholar
  • Dunnigan A, Pierpont ME, Smith SA, Breningstall G, Benditt DG, Benson DW, Jr. Cardiac and skeletal myopathy associated with cardiac dysrhythmias. Am J Cardiol. 1984;53(6):731-7. google scholar
  • Garson, A. Jr., McNamara, D.G. Sudden death in a pediatric cardiology population from 1958 to 1983: relation to prior arrhythmias. J Am Coll Cardiol. 1985;5(6 Suppl):134b-7b. google scholar
  • Pedersen DH, Zipes DP, Foster PR, Troup PJ. Ventricular tachycardia and ventricular fibrillation in a young population. Circulation. 1979;60(5):988-97. google scholar
  • Fulton DR, Chung KJ, Tabakin BS, Keane JF. Ventricular tachycardia in children without heart disease. Am J Cardiol. 1985;55(11):1328-31. google scholar
  • KEN Saito, K. Matsuyama, T. Niki, and H. Mori Characteristics of non-sustained ventricular tachycardia detected by ambulatory electrocardiography. Japanese Circulation Journal. 1984;48(5):421-6. google scholar
  • Lichstein E, Jonas S, Smith H, Jr., Chadda KD, Gupta PK, Sudberg L. Characteristics of ventricular ectopic beats in patients with ventricular tachycardia. A 24-hour Holter monitor study. Chest. 1980;77(6):731-5. google scholar
  • Zhu W, Yuan H, Lv J. Advancements in the diagnosis and management of premature ventricular contractions in pediatric patients. Front Pediatr. 2024;12:1373772. google scholar

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APA

Karaca, S., Özbingöl, D., Öztarhan, K., & Nişli, K. (2024). Evaluation of the Clinical Phenotype and Follow-up of Children with ‘Non sustained’ Ventricular Tachycardia Detected on 24-hour Rhythm Holter. Journal of Child, 24(4), 241-244. https://doi.org/10.26650/jchild.2024.1588249


AMA

Karaca S, Özbingöl D, Öztarhan K, Nişli K. Evaluation of the Clinical Phenotype and Follow-up of Children with ‘Non sustained’ Ventricular Tachycardia Detected on 24-hour Rhythm Holter. Journal of Child. 2024;24(4):241-244. https://doi.org/10.26650/jchild.2024.1588249


ABNT

Karaca, S.; Özbingöl, D.; Öztarhan, K.; Nişli, K. Evaluation of the Clinical Phenotype and Follow-up of Children with ‘Non sustained’ Ventricular Tachycardia Detected on 24-hour Rhythm Holter. Journal of Child, [Publisher Location], v. 24, n. 4, p. 241-244, 2024.


Chicago: Author-Date Style

Karaca, Serra, and Doruk Özbingöl and Kazım Öztarhan and Kemal Nişli. 2024. “Evaluation of the Clinical Phenotype and Follow-up of Children with ‘Non sustained’ Ventricular Tachycardia Detected on 24-hour Rhythm Holter.” Journal of Child 24, no. 4: 241-244. https://doi.org/10.26650/jchild.2024.1588249


Chicago: Humanities Style

Karaca, Serra, and Doruk Özbingöl and Kazım Öztarhan and Kemal Nişli. “Evaluation of the Clinical Phenotype and Follow-up of Children with ‘Non sustained’ Ventricular Tachycardia Detected on 24-hour Rhythm Holter.” Journal of Child 24, no. 4 (Mar. 2025): 241-244. https://doi.org/10.26650/jchild.2024.1588249


Harvard: Australian Style

Karaca, S & Özbingöl, D & Öztarhan, K & Nişli, K 2024, 'Evaluation of the Clinical Phenotype and Follow-up of Children with ‘Non sustained’ Ventricular Tachycardia Detected on 24-hour Rhythm Holter', Journal of Child, vol. 24, no. 4, pp. 241-244, viewed 10 Mar. 2025, https://doi.org/10.26650/jchild.2024.1588249


Harvard: Author-Date Style

Karaca, S. and Özbingöl, D. and Öztarhan, K. and Nişli, K. (2024) ‘Evaluation of the Clinical Phenotype and Follow-up of Children with ‘Non sustained’ Ventricular Tachycardia Detected on 24-hour Rhythm Holter’, Journal of Child, 24(4), pp. 241-244. https://doi.org/10.26650/jchild.2024.1588249 (10 Mar. 2025).


MLA

Karaca, Serra, and Doruk Özbingöl and Kazım Öztarhan and Kemal Nişli. “Evaluation of the Clinical Phenotype and Follow-up of Children with ‘Non sustained’ Ventricular Tachycardia Detected on 24-hour Rhythm Holter.” Journal of Child, vol. 24, no. 4, 2024, pp. 241-244. [Database Container], https://doi.org/10.26650/jchild.2024.1588249


Vancouver

Karaca S, Özbingöl D, Öztarhan K, Nişli K. Evaluation of the Clinical Phenotype and Follow-up of Children with ‘Non sustained’ Ventricular Tachycardia Detected on 24-hour Rhythm Holter. Journal of Child [Internet]. 10 Mar. 2025 [cited 10 Mar. 2025];24(4):241-244. Available from: https://doi.org/10.26650/jchild.2024.1588249 doi: 10.26650/jchild.2024.1588249


ISNAD

Karaca, Serra - Özbingöl, Doruk - Öztarhan, Kazım - Nişli, Kemal. “Evaluation of the Clinical Phenotype and Follow-up of Children with ‘Non sustained’ Ventricular Tachycardia Detected on 24-hour Rhythm Holter”. Journal of Child 24/4 (Mar. 2025): 241-244. https://doi.org/10.26650/jchild.2024.1588249



TIMELINE


Submitted20.11.2024
Accepted03.01.2025

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