title: The follow-up evaluation of electrocardiogram and arrhythmias in children with fulminant myocarditis.
abstract: BACKGROUND
  Fulminant myocarditis involves various serious arrhythmias that sometimes have lethal consequences. The purpose of the present study was to investigate the electrocardiogram findings, arrhythmogenicity and abnormalities of the cardiac conduction system in children with fulminant myocarditis.
  
  
  RESULTS
  Between 1999 and 2008, 7 consecutive patients (mean age: 7 years) who suffered from fulminant myocarditis were included in the study. A 12-lead electrocardiogram, Holter monitoring and signal-averaged electrocardiograms were performed and compared between the acute, convalescent, and recovery phases in the 4 surviving patients. Also, electrophysiologic assessment was carried out during the convalescent phase. Five out of 7 patients developed complete atrioventricular block, 3 developed ventricular tachycardia, 2 had cardiac arrest, 2 developed sinus tachycardia, 1 developed ventricular fibrillation, 1 had advanced atrioventricular block, and 1 developed sick sinus syndrome. Among the surviving patients, all arrhythmias resolved during the convalescent and remote phases. No atrial or ventricular arrhythmias were induced in any patients during the programmed stimulation study. In the convalescent phase, no arrhythmias could be induced and there were no signs of any conduction abnormalities on electrophysiological assessment.
  
  
  CONCLUSIONS
  Close follow-up should be performed to observe for the occurrence of any new arrhythmias and/or a decrease in cardiac function in children with fulminant myocarditis.
authors.affiliation: Department of Pediatrics and Child Health, Nihon University, School of Medicine, Tokyo, Japan.
authors.forename: Rie
authors.initials: R
authors.lastname: Ichikawa
authors.forename: Naokata
authors.initials: N
authors.lastname: Sumitomo
authors.forename: Akiko
authors.initials: A
authors.lastname: Komori
authors.forename: Yuriko
authors.initials: Y
authors.lastname: Abe
authors.forename: Takahiro
authors.initials: T
authors.lastname: Nakamura
authors.forename: Junji
authors.initials: J
authors.lastname: Fukuhara
authors.forename: Masaharu
authors.initials: M
authors.lastname: Matsumura
authors.forename: Michio
authors.initials: M
authors.lastname: Miyashita
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kanamaru
authors.forename: Mamoru
authors.initials: M
authors.lastname: Ayusawa
authors.forename: Hideo
authors.initials: H
authors.lastname: Mugishima
mesh_terms: D000293:Adolescent; D001145:Arrhythmias, Cardiac / Q000401:mortality / Q000473:pathology / Q000503:physiopathology*; D002675:Child, Preschool; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006329:Heart Conduction System / Q000473:pathology / Q000503:physiopathology*; D006801:Humans; D007223:Infant; D008297:Male; D009205:Myocarditis / Q000401:mortality / Q000473:pathology / Q000503:physiopathology*; D012189:Retrospective Studies