Allam Lamyaa Elsayed, Nabih Mervat Aboulmaaty, Helal Mohamed Basyouni, Allam Abdallah R, Ali Ahmed Nabil
Cardiology Department, Faculty of Medicine, Ain Shams University, 48 Mohammed Elnadi Street, 6Thzonezone, Nasr CityCairo, P0 11371, Egypt.
Faculty of Medicine, Menoufia University, Menoufia, Egypt.
Pediatr Cardiol. 2025 Feb 2. doi: 10.1007/s00246-025-03784-x.
Idiopathic premature ventricular contractions (PVCs) can occur in up to 40% of children with structurally normal hearts. The study aims to assess the impact of high-burden idiopathic PVCs on children in comparison with adults in terms of symptoms, distribution of origin, management strategies, and safety considerations. This is a single-center retrospective cohort study that included patients with frequent PVCs (> 10% burden in Holter monitoring) and categorized by age into adult group (≥ 18 years) and pediatric group. Data encompassed demographic profiles, clinical symptoms, echocardiographic findings, electrocardiographic analyses, and one-year follow-up management. A total of 224 PVC cases were collected during a 2-year study (120 children and 104 adults). Syncope occurred significantly more in children than adults (15.8% vs. 0.9%, p = 0.003). In children, the right ventricular outflow tract (RVOT) free wall was the predominant site (48 patients; 40%), while the septal RVOT was most common in adults (35 patients; 33.7%). Pediatric cases exhibited significantly higher PVCs originating from the outflow tract (92.5% vs. 69.2%; p = 0.001). Nevertheless, there were no significant differences between groups regarding the safety, acute, and one-year outcomes of RF ablation. Age disparities were evident in syncope incidence and PVC origin, with no variance in PVC-induced myopathy prevalence or the safety and outcomes of RF catheter ablation between children and adults.
特发性室性早搏（PVC）在心脏结构正常的儿童中发生率高达40%。本研究旨在比较高负荷特发性PVC对儿童和成人在症状、起源部位分布、管理策略及安全考量方面的影响。这是一项单中心回顾性队列研究，纳入频发PVC患者（动态心电图监测负荷>10%），并按年龄分为成人组（≥18岁）和儿童组。数据包括人口统计学资料、临床症状、超声心动图检查结果、心电图分析及一年的随访管理情况。在为期2年的研究中，共收集到224例PVC病例（120例儿童和104例成人）。儿童晕厥发生率显著高于成人（15.8%对0.9%，p = 0.003）。在儿童中，右心室流出道（RVOT）游离壁是主要起源部位（48例；40%），而在成人中，室间隔RVOT最常见（35例；33.7%）。儿童病例中起源于流出道的PVC显著更多（92.5%对69.2%；p = 0.001）。然而，在射频消融的安全性、急性期及一年期结局方面，两组之间无显著差异。晕厥发生率和PVC起源存在年龄差异，儿童和成人在PVC诱发的肌病患病率以及射频导管消融的安全性和结局方面无差异。
