[Ventricular tachycardia in children].
Ventricular tachycardia (VT) in children is different to that observed in the adult because ischemic heart disease is exceptionally rare in this age group. The arrhythmia sometimes presents with cardiac failure or loss of consciousness. VT complicates the outcome of operated Tetralogy of Fallot, arrhythmogenic right ventricular dysplasia and some cardiac tumours. Cardiomyopathies are also a cause of VT but it must be noted that ventricular dysfunction may be the result of a prolonged arrhythmia and will disappear after return to sinus rhythm. Many cases of childhood VT occur without any patent cardiac disease even after extensive investigations. Some are benign with a good prognosis, such as salvoes of VT or sustained attacks of so-called ventricular Bouveret. Others carry a more reserved prognosis and require active treatment. Incessant tachycardia of the newborn is difficult to stop may be cured without sequellae. Torsades de pointes is sometimes iatrogenic complicating congenitally long QT syndromes with or without deafness or familial nature, and which may be likened to adrenergic VT. Amiodarone and betablockers are the best antiarrhythmic agents. Investigations with a diagnostic or therapeutic objective are easier in older children but these techniques, whilst not being systematic, do not exclude the very young children. Ablation techniques progress and the limited indications of surgery and implantable defibrillators have to be considered case by case.
Grolleau
R
R
Service de cardiologie, hôpital Arnaud-de-Villeneuve, Montpellier.
Messner
P
P
Leclercq
F
F
Carabasse
D
D
Voisin
M
M
D000293:Adolescent; D000367:Age Factors; D009202:Cardiomyopathies / Q000150:complications; D002648:Child; D002675:Child, Preschool; D004562:Electrocardiography; D005260:Female; D006330:Heart Defects, Congenital / Q000150:complications; D006338:Heart Neoplasms / Q000150:complications; D006352:Heart Ventricles / Q000002:abnormalities; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008133:Long QT Syndrome / Q000150:complications; D008297:Male; D017180:Tachycardia, Ventricular / Q000175:diagnosis / Q000209:etiology*; D016278:Ventricular Function, Right
Les tachycardies ventriculaires de l'enfant.