High burden of premature ventricular contractions in structurally normal hearts : To worry or not in pediatric patients?

Background: There is paucity of data regarding the significance of high percentage of premature ventricular contractions (PVCs) in healthy children and their impact on left ventricular (LV) function and the risk of ventricular arrhythmias. The purpose of this study was to assess the prevalence of LV systolic dysfunction in children with frequent PVCs and determine whether PVC characteristics were predictive of LV dysfunction. Methods: We performed a single-center retrospective review to examine the prevalence of PVC-induced cardiomyopathy and natural history of PVC burden in children with frequent PVCs. Children aged 6 months–21 years with PVCs noted on 24-hr Holter monitoring studies were enrolled. The four categories included those with a PVC burden of >10%, 10%–20%, and those with more than 20% PVC burden. Results: A total of 134 children were included, 65 with more than 10% PVCs and 31 with more than 20% PVCs. Median age of the patients was 10.5 years (IQR 6.1–14.8 years), with 79 males (54.5%). Median PVC burden was 8.7% (IQR 4.2%–16.9%) with median follow-up of 2.8 years (IQR 1.2–4.6 years). During 2.8 years (1.3–4.3 years) of follow-up, the PVC burden decreased by 67% of baseline PVC burden in those who did not undergo any intervention. There were no deaths. Conclusion: PVCs in children with structurally normal hearts are associated with a relatively benign course, with trend toward spontaneous resolution