title: Diagnosis-specific characteristics of ventricular tachycardia in children with structurally normal hearts.
abstract: BACKGROUND
  Improved mechanistic insights and clinical tools provide increasing diagnostic refinement for ventricular tachycardia in young patients with structurally normal hearts, yielding potentially important prognostic and management implications.
  
  
  OBJECTIVE
  The purpose of this study was to survey the clinical characteristics and outcomes of otherwise healthy children with ventricular tachycardia (VT) who were classified according to contemporary diagnostic criteria.
  
  
  METHODS
  A single-center retrospective review of patients younger than 18 years of age with VT diagnosed between January 1980 and December 2005 was undertaken. Patients with significant systemic illness or with underlying structural or functional heart disease were excluded.
  
  
  RESULTS
  A total of 77 patients met inclusion criteria and were grouped as follows: accelerated idioventricular rhythm (AIVR; n = 19), right ventricular tachycardia (RVT; n = 30), left ventricular tachycardia (LVT; n = 23), and catecholamine sensitive polymorphic VT (CPVT; n = 5). AIVR patients were youngest at diagnosis and had the most benign natural history, while the opposite was true of CPVT patients. Ablation was attempted in 2/30 RVT (50% success) and 10/23 LVT (80% success) patients. Severe cardiac events occurred in 3/23 LVT (no deaths) and 2/5 CPVT (one death) patients.
  
  
  CONCLUSIONS
  The natural history and appropriate management of VT in young patients with structurally normal hearts are highly dependent on the specific diagnosis. LVT and CPVT are associated with significantly greater morbidity and mortality than AIVR and RVT.
authors.affiliation: Cardiology Division, The Hospital for Sick Children, Toronto, Ontario, Canada.
authors.forename: Samuel
authors.initials: S
authors.lastname: Wang
authors.forename: Wei
authors.initials: W
authors.lastname: Zhu
authors.forename: Robert M
authors.initials: RM
authors.lastname: Hamilton
authors.forename: Joel A
authors.initials: JA
authors.lastname: Kirsh
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Stephenson
authors.forename: Gil J
authors.initials: GJ
authors.lastname: Gross
mesh_terms: D000293:Adolescent; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D017115:Catheter Ablation; D002648:Child; D002675:Child, Preschool; D015716:Electrocardiography, Ambulatory; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012189:Retrospective Studies; D017180:Tachycardia, Ventricular / Q000145:classification / Q000175:diagnosis* / Q000188:drug therapy / Q000628:therapy
chemical_list: D002121:Calcium Channel Blockers