Fascicular and Nonfascicular Left Ventricular Tachycardias in the Young: An International Multicenter Study
Corresponding Author
KATHRYN K. COLLINS M.D.
Division of Cardiology, Department of Pediatrics, The Children's Hospital, University of Colorado, Denver, Colorado, USA
Address for correspondence: Kathryn K. Collins, M.D., Children's Hospital Colorado, Department of Cardiology/B100, 13123 E 16th Avenue, Aurora, CO 80045, USA. Fax: 720-777-7290; E-mail: kathryn.collins@childrens colorado.orgSearch for more papers by this authorMICHAEL S. SCHAFFER M.D.
Division of Cardiology, Department of Pediatrics, The Children's Hospital, University of Colorado, Denver, Colorado, USA
Search for more papers by this authorLEONARDO LIBERMAN M.D.
Division of Cardiology, Department of Pediatrics, Children's Hospital of NY-Presbyterian, New York, New York, USA
Search for more papers by this authorELIZABETH SAAREL M.D.
Division of Cardiology, Department of Pediatrics, Primary Children's Hospital, Salt Lake City, Utah, USA
Search for more papers by this authorMARIA KNECHT M.D.
Division of Cardiology, Department of Pediatrics, The Children's Memorial Health Insitute, Warsaw, Poland
Search for more papers by this authorRONN E. TANEL M.D.
Division of Cardiology, Department of Pediatrics, University of California, San Francisco, California, USA
Search for more papers by this authorDAVID BRADLEY M.D.
Division of Cardiology, Department of Pediatrics, C. S. Mott Children's Hospital, Ann Arbor, Michigan, USA
Search for more papers by this authorANNE M. DUBIN M.D.
Division of Cardiology, Department of Pediatrics, Stanford University, Palo Alto, California, USA
Search for more papers by this authorTHOMAS PAUL M.D.
Division of Cardiology, Department of Pediatrics, Georg-August-University, Göttingen, Germany
Search for more papers by this authorJACK SALERNO M.D.
Division of Cardiology, Department of Pediatrics, Children's Heart Center, Seattle, Washington, USA
Search for more papers by this authorYANIV BAR-COHEN M.D.
Division of Cardiology, Department of Pediatrics, Children's Hospital, Los Angeles, California, USA
Search for more papers by this authorNARAYANSWAMI SREERAM M.D.
Division of Cardiology, Department of Pediatrics, University Hospital of Cologne, Koln, Germany
Search for more papers by this authorSHUBHAYAN SANATANI M.D.
Division of Cardiology, Department of Pediatrics, British Columbia Children's Hospital, Vancouver, British Columbia, Canada
Search for more papers by this authorIAN H. LAW M.D.
Division of Cardiology, Department of Pediatrics, University of Iowa Children's Hospital, Iowa City, Iowa, USA
Search for more papers by this authorANDREW BLAUFOX M.D.
Division of Cardiology, Department of Pediatrics, Steven and Alexandra Cohen Children's Medical Center of New York, New Hyde Park, New York, USA
Search for more papers by this authorANJAN BATRA M.D.
Division of Cardiology, Department of Pediatrics, Childrens Hospital of Orange County, University of California-Irvine, Orange, California, USA
Search for more papers by this authorJOSE M. MOLTEDO M.D.
Division of Cardiology, Department of Pediatrics, Clinica y Maternidad Suizo Argentina, Buenos Aires, Argentina
Search for more papers by this authorGEORGE F. VAN HARE M.D.
Division of Cardiology, Department of Pediatrics, Washington University School of Medicine/St. Louis Children's Hospital, St. Louis, Missouri, USA
Search for more papers by this authorJOHN REED M.D.
Division of Cardiology, Department of Pediatrics, Medical University of South Carolina, Charleston, South Carolina, USA
Search for more papers by this authorPAMELA S. RO M.D.
Division of Cardiology, Department of Pediatrics, Nationwide Children's Hospital, Columbus, Ohio, USA
Search for more papers by this authorJOHN KUGLER M.D.
Division of Cardiology, Department of Pediatrics, Nebraska Medical Center, Omaha, Nebraska, USA
Search for more papers by this authorCHRIS ANDERSON M.D.
Division of Cardiology, Department of Pediatrics, Northwest Center for Congenital Heart Disease, Spokane, Washington, USA
Search for more papers by this authorJOHN K. TRIEDMAN M.D.
Division of Cardiology, Department of Pediatrics, Children's Hospital, Boston, Massachusetts, USA
Search for more papers by this authoron behalf of members of the Pediatric and Congenital Electrophysiology Society
Search for more papers by this authorCorresponding Author
KATHRYN K. COLLINS M.D.
Division of Cardiology, Department of Pediatrics, The Children's Hospital, University of Colorado, Denver, Colorado, USA
Address for correspondence: Kathryn K. Collins, M.D., Children's Hospital Colorado, Department of Cardiology/B100, 13123 E 16th Avenue, Aurora, CO 80045, USA. Fax: 720-777-7290; E-mail: kathryn.collins@childrens colorado.orgSearch for more papers by this authorMICHAEL S. SCHAFFER M.D.
Division of Cardiology, Department of Pediatrics, The Children's Hospital, University of Colorado, Denver, Colorado, USA
Search for more papers by this authorLEONARDO LIBERMAN M.D.
Division of Cardiology, Department of Pediatrics, Children's Hospital of NY-Presbyterian, New York, New York, USA
Search for more papers by this authorELIZABETH SAAREL M.D.
Division of Cardiology, Department of Pediatrics, Primary Children's Hospital, Salt Lake City, Utah, USA
Search for more papers by this authorMARIA KNECHT M.D.
Division of Cardiology, Department of Pediatrics, The Children's Memorial Health Insitute, Warsaw, Poland
Search for more papers by this authorRONN E. TANEL M.D.
Division of Cardiology, Department of Pediatrics, University of California, San Francisco, California, USA
Search for more papers by this authorDAVID BRADLEY M.D.
Division of Cardiology, Department of Pediatrics, C. S. Mott Children's Hospital, Ann Arbor, Michigan, USA
Search for more papers by this authorANNE M. DUBIN M.D.
Division of Cardiology, Department of Pediatrics, Stanford University, Palo Alto, California, USA
Search for more papers by this authorTHOMAS PAUL M.D.
Division of Cardiology, Department of Pediatrics, Georg-August-University, Göttingen, Germany
Search for more papers by this authorJACK SALERNO M.D.
Division of Cardiology, Department of Pediatrics, Children's Heart Center, Seattle, Washington, USA
Search for more papers by this authorYANIV BAR-COHEN M.D.
Division of Cardiology, Department of Pediatrics, Children's Hospital, Los Angeles, California, USA
Search for more papers by this authorNARAYANSWAMI SREERAM M.D.
Division of Cardiology, Department of Pediatrics, University Hospital of Cologne, Koln, Germany
Search for more papers by this authorSHUBHAYAN SANATANI M.D.
Division of Cardiology, Department of Pediatrics, British Columbia Children's Hospital, Vancouver, British Columbia, Canada
Search for more papers by this authorIAN H. LAW M.D.
Division of Cardiology, Department of Pediatrics, University of Iowa Children's Hospital, Iowa City, Iowa, USA
Search for more papers by this authorANDREW BLAUFOX M.D.
Division of Cardiology, Department of Pediatrics, Steven and Alexandra Cohen Children's Medical Center of New York, New Hyde Park, New York, USA
Search for more papers by this authorANJAN BATRA M.D.
Division of Cardiology, Department of Pediatrics, Childrens Hospital of Orange County, University of California-Irvine, Orange, California, USA
Search for more papers by this authorJOSE M. MOLTEDO M.D.
Division of Cardiology, Department of Pediatrics, Clinica y Maternidad Suizo Argentina, Buenos Aires, Argentina
Search for more papers by this authorGEORGE F. VAN HARE M.D.
Division of Cardiology, Department of Pediatrics, Washington University School of Medicine/St. Louis Children's Hospital, St. Louis, Missouri, USA
Search for more papers by this authorJOHN REED M.D.
Division of Cardiology, Department of Pediatrics, Medical University of South Carolina, Charleston, South Carolina, USA
Search for more papers by this authorPAMELA S. RO M.D.
Division of Cardiology, Department of Pediatrics, Nationwide Children's Hospital, Columbus, Ohio, USA
Search for more papers by this authorJOHN KUGLER M.D.
Division of Cardiology, Department of Pediatrics, Nebraska Medical Center, Omaha, Nebraska, USA
Search for more papers by this authorCHRIS ANDERSON M.D.
Division of Cardiology, Department of Pediatrics, Northwest Center for Congenital Heart Disease, Spokane, Washington, USA
Search for more papers by this authorJOHN K. TRIEDMAN M.D.
Division of Cardiology, Department of Pediatrics, Children's Hospital, Boston, Massachusetts, USA
Search for more papers by this authoron behalf of members of the Pediatric and Congenital Electrophysiology Society
Search for more papers by this authorJ.K. Triedman serves as consultant to Biosense Webster. Other authors:
No disclosures.
Left Ventricular Tachycardia in Pediatrics
Introduction
The aim of this study was to evaluate the clinical presentation and outcomes of pediatric patients with ventricular tachycardia (VT) originating from left heart structures.
Methods and Results
This international multicenter retrospective study including 152 patients (age 10.0 ± 5.1 years, 62% male), divided into those with fascicular VT (85%, 129/152) and nonfascicular LV VT (15%, 23/152). All patients had a normal heart structure or only a minor cardiac abnormality. Adenosine was largely ineffective in both groups (tachycardia termination in 4/74 of fascicular VT and 0/5 of nonfascicular LV VT). In fascicular VT, calcium channel blockers were effective in 80% (74/92); however, when administered orally, there was a 21% (13/62) recurrence rate. In nonfascicular LV VT, a variety of antiarrhythmic therapies were used with no one predominating. Ablation procedures were successful in 71% (72/102) of fascicular VT and 67% (12/18) of nonfascicular LV VT on an intention to treat analysis. Major complications occurred in 5 patients with fascicular VT and 1 patient with nonfascicular LV VT. After a follow-up period of 2 years (1 day to 15 years), 72% of all patients with fascicular VT were off medications with no tachycardia recurrence. One patient died of noncardiac causes. In nonfascicular LV VT, follow-up was 3.5 years (0.5–15 years), P = 0.38. A total of 65% of these patients were free from arrhythmias. Two patients died suddenly (P < 0.01).
Conclusion
The clinical course and outcomes of pediatric patients with fascicular VT and nonfascicular LV VT are varied. Catheter ablation procedures can be curative.
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