Primary ventricular tachycardia in paediatric population in a tertiary centre.

OBJECTIVE: To delineate the outcome of ventricular tachycardia (VT) in the paediatric population.

METHODS: Patients who developed sustained VT between the ages of 0 and 18 years in a referral centre from 1991 to 2015 were enrolled.

RESULTS: A total of 116 patients (67 male/49 female) had documented VT, and 53 (46%) had associated heart disease, namely cardiomyopathy in 20 (17%), structural heart disease in 19 (16%) and channelopathy in 14 (12%), and some of them presented with two types of associated heart disease. Idiopathic VT (63 patients), which presents without associated heart disease, was the most common type. Forty-one patients received catheter ablation, with 37 being successful (90%) and 6 of 37 recurrence (16%). None of the patients died during the 5.8±5.9 year follow-up. VT with cardiomyopathy was associated with the highest mortality rate, particularly in those with hypertrophic and restrictive cardiomyopathy. Among 16 patients initially presenting VT and heart failure, seven exhibited improved heart function after VT control, which could be predicted by benign onset symptoms, monomorphic QRS morphology and the presentation of VT at the initial diagnosis of cardiomyopathy. VT associated with structural heart disease was also associated with a high risk of mortality, but this risk decreased after aggressive intervention in the recent years. VT with channelopathy can be often controlled with medication, except for those with prenatal onset.

CONCLUSIONS: Although VT may carry high mortality when associated with structural anomaly or cardiomyopathy, VT presenting to tertiary referral centre often has a favourable outcome after prompt intervention.