Idiopathic sustained left ventricular tachycardia in pediatric patients.
BACKGROUND
Idiopathic sustained ventricular tachycardia originating from the left ventricle (ILVT) has been an indication for catheter ablation. The present study evaluated the clinical features, long-term prognosis and indications for treatment in pediatric patients with ILVT.


METHODS
The subjects of the present study were eight patients (four males and four females) with a mean age at onset of 11.0 years (range 3-15 years). The mean follow-up period was 7.7 years (range 2.1-11.3 years).


RESULTS
In electrophysiologic studies, intravenously administered verapamil was effective for the termination of tachycardia in all six patients who received this treatment and for the prevention of tachycardia in four of five patients. Oral administration of verapamil was effective in five of seven patients. Propranolol or flecainide was added to the treatment protocol for two patients who did not respond to verapamil alone. Tachycardia disappeared without drugs in four patients during the follow-up period and became non-sustained in another patient. Two of three patients with persistent tachycardia underwent catheter ablation. Pharmacologic treatment was very effective for ILVT among these patients.


CONCLUSIONS
Pharmacologic therapy, such as with verapamil, is still the treatment of choice for ILVT because of a good long-term prognosis and potential risks and complications by manipulation of catheter ablation.
Yasui
K
K
Department of Pediatrics, Yokohama City University Medical Center, Yokohama, Japan. kyasui@urahp.yokohama-cu.ac.jp
Shibata
T
T
Yokoyama
U
U
Nishizawa
T
T
Takigiku
K
K
Sakon
T
T
Kobayashi
H
H
Iwamoto
M
M
Niimura
I
I
D000293:Adolescent; D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D004594:Electrophysiology; D005260:Female; D005424:Flecainide / Q000627:therapeutic use; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011379:Prognosis; D011433:Propranolol / Q000627:therapeutic use; D017180:Tachycardia, Ventricular / Q000188:drug therapy*; D016896:Treatment Outcome; D014700:Verapamil / Q000008:administration & dosage / Q000627:therapeutic use*
D000889:Anti-Arrhythmia Agents; D011433:Propranolol; D014700:Verapamil; D005424:Flecainide