Tsuji A, Nagashima M, Hasegawa S, Nagai N, Nishibata K, Goto M, Matsushima M
Department of Pediatrics, Hekinan Municipal Hospital, Aichi prefecture, Japan.
Jpn Circ J. 1995 Oct;59(10):654-62. doi: 10.1253/jcj.59.654.
Clinical characteristics and long-term prognosis of 163 children with ventricular arrhythmias without underlying heart diseases (78 with ventricular premature contractions (VPC group), 39 with ventricular couplets (CPLT group), and 46 with ventricular tachycardia (VT group)) were studied by Holter electrocardiographic monitoring (Holter ECG) and treadmill exercise testing. The age of the subjects at the initial examination was 8.9 +/- 3.4 years in the VPC group, 9.9 +/- 3.5 years in CPLT group, and 9.4 +/- 3.1 years in the VT group. The duration of the follow-up was 71.7 +/- 32.1 months in the VPC group, 65.9 +/- 32.8 months in the CPLT group, and 84.0 +/- 31.9 months in the VT group. VPC's disappeared during the follow-up period in 22 (28%) of the 78 children in the VPC group. CPLT's disappeared in 15 (38%) and VPC's disappeared in 9 (23%) of the 39 children in the CPLT group. In the 46 children in the VT group, VT disappeared in 30 (65%), and VPC's disappeared in 17 (37%). One child (2%) in the VT group died of heart failure due to drug-resistant sustained VT. The mean time until the disappearance of VPC's in the 163 patients was estimated to be 115.2 +/- 4.3 months. The mean time until the disappearance of VT in the 46 children in the VT group was estimated to be 89.0 +/- 4.9 months. Multivariate analysis of prognostic factors related to the disappearance of VPC's indicated that nighttime VPC's were significantly more likely to disappear (p = 0.018), and that symptomatic VT was significantly more likely to disappear than asymptomatic VT (p = 0.032), probably because more symptomatic cases received antiarrhythmic therapy. Ventricular arrhythmias in children without underlying diseases often disappeared, and the prognosis was generally favorable. However, appropriate treatment and follow-up were required in children with sustained VT, symptomatic VT, or VT with a high rate of VT.
通过动态心电图监测（Holter心电图）和跑步机运动试验，对163例无基础心脏病的室性心律失常患儿（78例室性早搏（VPC组）、39例成对室性早搏（CPLT组）和46例室性心动过速（VT组））的临床特征和长期预后进行了研究。VPC组初次检查时受试者年龄为8.9±3.4岁，CPLT组为9.9±3.5岁，VT组为9.4±3.1岁。VPC组随访时间为71.7±32.1个月，CPLT组为65.9±32.8个月，VT组为84.0±31.9个月。VPC组78例患儿中有22例（28%）在随访期间室性早搏消失。CPLT组39例患儿中有15例（38%）成对室性早搏消失，9例（23%）室性早搏消失。VT组46例患儿中，30例（65%）室性心动过速消失，17例（37%）室性早搏消失。VT组有1例患儿（2%）因耐药性持续性室性心动过速死于心力衰竭。163例患者室性早搏消失的平均时间估计为115.2±4.3个月。VT组46例患儿室性心动过速消失的平均时间估计为89.0±4.9个月。对与室性早搏消失相关的预后因素进行多因素分析表明，夜间室性早搏更有可能消失（p = 0.018），有症状的室性心动过速比无症状的室性心动过速更有可能消失（p = 0.032），这可能是因为更多有症状的病例接受了抗心律失常治疗。无基础疾病患儿的室性心律失常常可消失，预后一般良好。然而，对于持续性室性心动过速、有症状的室性心动过速或室性心动过速发生率高的患儿，需要进行适当的治疗和随访。
