Fulton D R, Chung K J, Tabakin B S, Keane J F
Am J Cardiol. 1985 May 1;55(11):1328-31. doi: 10.1016/0002-9149(85)90498-9.
To assess the natural history of ventricular tachycardia (VT) in children without heart disease, the clinical course of 26 children, aged 1 day to 15 years at initial detection, was reviewed. Symptoms related to the rhythm were present in 8 children at some time during their course of follow-up. Evaluation included echocardiogram (19 patients), Holter monitoring (22 patients), graded treadmill exercise testing (16 patients) and invasive electrophysiology (4 patients). Exercise induced or exacerbated VT in 9 patients, but suppressed rhythm in 7. Ten patients were never treated. Of the remaining 16 treated patients, therapy was discontinued in 10 on the basis of the electrocardiographic or Holter monitor recordings. Six continued to receive therapy without complications. There were no known deaths over a period of 1 month to 34 years (mean 59 months, median 42 months). Although 2 patients have been lost to follow-up, based on our findings and a review of the reported cases of VT in children to date, after undergoing complete noninvasive cardiac evaluation symptomatic patients should be treated and studied with invasive electrophysiology if antiarrhythmic control is inadequate. The rate of VT or age at onset are not predictive of outcome in asymptomatic patients. As a group, these patients do not appear to benefit from therapy, but warrant follow-up since deaths have been reported in untreated asymptomatic patients.
为评估无心脏病儿童室性心动过速（VT）的自然病史，回顾了26例初诊时年龄为1天至15岁儿童的临床病程。在随访过程中的某个时间，8名儿童出现了与心律失常相关的症状。评估包括超声心动图（19例患者）、动态心电图监测（22例患者）、分级运动平板试验（16例患者）和有创电生理检查（4例患者）。运动诱发或加重了9例患者的室性心动过速，但使7例患者的心律得到抑制。10例患者从未接受治疗。其余16例接受治疗的患者中，10例根据心电图或动态心电图监测记录停止了治疗。6例继续接受治疗且无并发症。在1个月至34年的时间里（平均59个月，中位数42个月）没有已知的死亡病例。虽然有2例患者失访，但根据我们的研究结果以及对迄今为止报道的儿童室性心动过速病例的回顾，在进行了全面的无创心脏评估后，有症状的患者如果抗心律失常控制不佳，应接受有创电生理检查进行治疗和研究。室性心动过速的发生率或发病年龄并不能预测无症状患者的预后。总体而言，这些患者似乎无法从治疗中获益，但鉴于有未经治疗的无症状患者死亡的报道，仍需进行随访。
