Journal of Clinical Pediatrics >
Clinical features of idiopathic premature ventricular contractions in children and its influence on left ventricular function
Received date: 2023-02-21
Online published: 2023-12-04
Objective To investigate the clinical features of idiopathic premature ventricular contractions (PVCs) in children, and to analyze the risk factors leading to left ventricular (LV) dysfunction. Methods The clinical data of idiopathic PVCs children hospitalized from July 2015 to December 2020 were retrospectively analyzed. Patients followed up for more than 3 years were divided into LVEF reduction group and LVEF unchanged group according to the left ventricular ejection fraction (LVEF) assessed by echocardiography at the third year. The risk factors of LVEF reduction in idiopathic PVCs children were analyzed. Results A total of 393 children with idiopathic PVCs (227 boys and 166 girls) were included, and the median age was 5.0 (2.0-8.0) years. Sixty-six children with symptoms mainly presented as chest tightness and chest pain and 273 cases of PVCs originated from right ventricle. The burden of PVCs in 284 children was less than 10%, and the highest burden was 46%. Two hundred and twelve children were followed up regularly within 2 years, and the total improvement rate at 24 months was 73.6%. There was no statistically difference in the recovery rate between patients with and without antiarrhythmic drugs (P>0.05). One hundred and forty-seven children were followed up for more than 3 years including 23 children in LVEF reduction group and 124 children in LVEF unchanged group. There were significant differences in the proportion of unsustained ventricular tachycardia and PVCs burden between the two groups (P<0.05).Multivariate logistic regression analysis showed that increased PVCs burden was an independent risk factor for LVEF reduction in idiopathic PVCs children (P<0.05), and the area under the ROC curve for predicting LVEF reduction in idiopathic PVCs children was 0.88 (95%CI: 0.79-0.96). Conclusions Idiopathic PVCs in children usually has no obvious symptoms, most of the children have a good prognosis, and antiarrhythmic drugs cannot improve the prognosis of PVCs in children. Children with idiopathic PVCs may occur LV dysfunction during a long follow-up period. The PVCs burden can be used as a predictor of LV dysfunction in children with idiopathic PVCs.
Ye CHEN , Wanping ZHOU , Xuan LI , Miao HOU , Lei CAO , Ling SUN , Haitao LYU . Clinical features of idiopathic premature ventricular contractions in children and its influence on left ventricular function[J]. Journal of Clinical Pediatrics, 2023 , 41(12) : 925 -930 . DOI: 10.12372/jcp.2023.23e0116
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