title: Premature ventricular contraction-induced cardiomyopathy in children.
abstract: BACKGROUND
  Adults with high premature ventricular contraction burden can develop left ventricular dilation, dysfunction, and strain, consistent with a cardiomyopathy, which is reversible with radiofrequency ablation of the premature ventricular contractions. Evidence in children with similar ectopy burden is limited. We performed a single-centre retrospective review to examine the prevalence of premature ventricular contraction-induced cardiomyopathy, natural history of ventricular ectopy, and progression to ventricular tachycardia in children with frequent premature ventricular contractions.
  
  
  METHODS
  Children aged between 6 months and 18 years, with premature ventricular contractions comprising at least 20% of rhythm on 24-hour Holter monitor, were included in our study. Those with significant structural heart disease, ventricular tachycardia greater than 1% of rhythm at the time of premature ventricular contraction diagnosis, or family history of cardiomyopathy - except tachycardia-induced - were excluded. Cardiomyopathy was defined by echocardiographic assessment.
  
  
  RESULTS
  A total of 36 children met the study criteria; seven patients (19.4%, 95% CI 6.2-32.6%) met the criteria for cardiomyopathy, mostly at initial presentation. Ectopy decreased to <10% of beats without intervention in 16.7% (95% CI 4.3-29.1%) of the patients. No patient progressed to having ventricular tachycardia as more than 1% of beats on follow-up Holter. Radiofrequency ablation was performed in three patients without cardiomyopathy.
  
  
  CONCLUSIONS
  Our study demonstrates a higher prevalence of cardiomyopathy among children with high premature ventricular contraction burden than that previously shown. Ectopy tended to persist throughout follow-up. These trends suggest the need for a multi-centre study on frequent premature ventricular contractions in children. In the interim, regular follow-up with imaging to evaluate for cardiomyopathy is warranted.
authors.affiliation: Division of Pediatric Cardiology,Seattle Children's Hospital Heart Center,Seattle,Washington,United States of America.
authors.forename: Zebulon Z
authors.initials: ZZ
authors.lastname: Spector
authors.affiliation: Division of Pediatric Cardiology,Seattle Children's Hospital Heart Center,Seattle,Washington,United States of America.
authors.forename: Stephen P
authors.initials: SP
authors.lastname: Seslar
mesh_terms: D000293:Adolescent; D009202:Cardiomyopathies / Q000209:etiology*; D002648:Child; D002675:Child, Preschool; D018450:Disease Progression; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D012189:Retrospective Studies; D017180:Tachycardia, Ventricular / Q000209:etiology; D018879:Ventricular Premature Complexes / Q000150:complications*
keywords: Cardiomyopathy; child; ectopy; premature ventricular contractions