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正常儿童的室性早搏

Premature ventricular contractions in normal children.

作者信息

Cağdaş Deniz, Celiker Alpay, Ozer Sema

机构信息

Turkey Yüksek Ihtisas Hospital, Hacettepe University Faculty of Medicine, Ankara, Turkey.

出版信息

Turk J Pediatr. 2008 May-Jun;50(3):260-4.

Abstract

Premature ventricular contractions (PVCs) are frequently seen in children with normal cardiac findings. The purpose of this study was to evaluate the characteristics and the prognosis of PVCs in children with normal heart. This study included 149 children with PVC who did not have systemic or cardiac disease. Their median age at diagnosis was 10 years (range 1 month to 17 years). Seventy-six children (51%) were symptomatic. Most of the patients had unifocal PVC, whereas 5 (3.1%) of them had multifocal PVCs. The patients were evaluated by repeated Holter recordings and exercise test. In the first Holter monitoring recordings, PVCs were in the form of isolated PVC in 122 (82%) patients, couplet-triplet in 14 (9%) patients and nonsustained ventricular tachycardia in 13 (9%) patients. The exercise test was performed in 105 (70.5%) patients. The frequency of PVCs decreased and disappeared in 65 (61.9%) children, increased in 8 (7.6%), and were unchanged during exercise in 32 (30.5%). There was no difference between the groups according to exercise response regarding PVC quantity. Fifty-two of 149 children (35%) were followed up for a median period of 22 months. After follow-up, PVCs of 25 of the 52 patients (48.1%) decreased and disappeared. We did not find any correlation between the frequency of PVC and treatment, age, gender or the PVC frequency decrease with exercise. In conclusion, PVCs in normal children have benign prognosis and during follow-up a considerable percent show improvement.

摘要

室性早搏(PVCs)在心脏检查正常的儿童中很常见。本研究的目的是评估心脏正常的儿童室性早搏的特征和预后。本研究纳入了149例无全身性或心脏疾病的室性早搏患儿。他们诊断时的中位年龄为10岁(范围1个月至17岁)。76例(51%)患儿有症状。大多数患者为单源性室性早搏,其中5例(3.1%)为多源性室性早搏。通过重复动态心电图记录和运动试验对患者进行评估。在首次动态心电图监测记录中,122例(82%)患者的室性早搏为孤立性室性早搏,14例(9%)患者为成对-三联律,13例(9%)患者为非持续性室性心动过速。105例(70.5%)患者进行了运动试验。65例(61.9%)儿童的室性早搏频率降低并消失,8例(7.6%)增加,32例(30.5%)在运动期间无变化。根据运动反应,两组在室性早搏数量方面没有差异。149例儿童中有52例(35%)接受了中位时间为22个月的随访。随访后,52例患者中有25例(48.1%)的室性早搏减少并消失。我们未发现室性早搏频率与治疗、年龄、性别或运动导致的室性早搏频率降低之间存在任何相关性。总之,正常儿童的室性早搏预后良好,在随访期间相当一部分患儿病情有所改善。

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