title: Fascicular and nonfascicular left ventricular tachycardias in the young: an international multicenter study.
abstract: BACKGROUND
  The aim of this study was to evaluate the clinical presentation and outcomes of pediatric patients with ventricular tachycardia (VT) originating from left heart structures.
  
  
  RESULTS
  This international multicenter retrospective study including 152 patients (age 10.0 ± 5.1 years, 62% male), divided into those with fascicular VT (85%, 129/152) and nonfascicular LV VT (15%, 23/152). All patients had a normal heart structure or only a minor cardiac abnormality. Adenosine was largely ineffective in both groups (tachycardia termination in 4/74 of fascicular VT and 0/5 of nonfascicular LV VT). In fascicular VT, calcium channel blockers were effective in 80% (74/92); however, when administered orally, there was a 21% (13/62) recurrence rate. In nonfascicular LV VT, a variety of antiarrhythmic therapies were used with no one predominating. Ablation procedures were successful in 71% (72/102) of fascicular VT and 67% (12/18) of nonfascicular LV VT on an intention to treat analysis. Major complications occurred in 5 patients with fascicular VT and 1 patient with nonfascicular LV VT. After a follow-up period of 2 years (1 day to 15 years), 72% of all patients with fascicular VT were off medications with no tachycardia recurrence. One patient died of noncardiac causes. In nonfascicular LV VT, follow-up was 3.5 years (0.5-15 years), P = 0.38. A total of 65% of these patients were free from arrhythmias. Two patients died suddenly (P < 0.01).
  
  
  CONCLUSIONS
  The clinical course and outcomes of pediatric patients with fascicular VT and nonfascicular LV VT are varied. Catheter ablation procedures can be curative.
authors: Division of Cardiology, Department of Pediatrics, The Children's Hospital, University of Colorado, Denver, CO, USA. kathryn.collins@childrenscolorado.org
authors: Kathryn K
authors: KK
authors: Collins
authors: Michael S
authors: MS
authors: Schaffer
authors: Leonardo
authors: L
authors: Liberman
authors: Elizabeth
authors: E
authors: Saarel
authors: Maria
authors: M
authors: Knecht
authors: Ronn E
authors: RE
authors: Tanel
authors: David
authors: D
authors: Bradley
authors: Anne M
authors: AM
authors: Dubin
authors: Thomas
authors: T
authors: Paul
authors: Jack
authors: J
authors: Salerno
authors: Yaniv
authors: Y
authors: Bar-Cohen
authors: Narayanswami
authors: N
authors: Sreeram
authors: Shubhayan
authors: S
authors: Sanatani
authors: Ian H
authors: IH
authors: Law
authors: Andrew
authors: A
authors: Blaufox
authors: Anjan
authors: A
authors: Batra
authors: Jose M
authors: JM
authors: Moltedo
authors: George F
authors: GF
authors: van Hare
authors: John
authors: J
authors: Reed
authors: Pamela S
authors: PS
authors: Ro
authors: John
authors: J
authors: Kugler
authors: Chris
authors: C
authors: Anderson
authors: John K
authors: JK
authors: Triedman
mesh_terms: D000241:Adenosine / Q000627:therapeutic use; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D017115:Catheter Ablation; D002648:Child; D017147:Defibrillators, Implantable; D004452:Echocardiography; D004554:Electric Countershock; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D017180:Tachycardia, Ventricular / Q000150:complications / Q000401:mortality / Q000628:therapy; D016896:Treatment Outcome
chemical_list: D002121:Calcium Channel Blockers; D000241:Adenosine