RECURRENT VENTRICULAR-TACHYCARDIA IN ASYMPTOMATIC YOUNG-CHILDREN WITH AN APPARENTLY NORMAL HEART

Ventricular tachycardia without underlying heart disease is rare in infancy and childhood. Four young children (median age 8 months at initial presentation) with frequently recurrent episodes of asymptomatic and self-limiting ventricular tachycardia are reported. By noninvasive investigation no apparent heart disease has been found in all patients, Initially three of the four children had been treated with an anti-arrhythmic drug. Treatment was soon stopped in two patients for lack of symptoms and for lack of efficacy of therapy; one patient remained on beta-blocker therapy, One child did not receive anti-arrhythmic therapy. After a mean follow up of 32 months all patients continued to be asymptomatic despite frequently recurrent episodes of self-limiting ventricular tachycardia. Conclusion Ventricular tachycardia in asymptomatic children with an otherwise normal heart carries a good prognosis. Invasive investigation (cardiac catheterization with electrophysiological study and right ventricular biopsy) can be withhold, as long as there are no symptoms, For lack of efficiency of anti-arrhythmic drugs in suppressing ventricular tachycardia in asymptomatic children with apparently normal hearts, these patients map be left without therapy but have to be followed closely.