Fascicular and nonfascicular left ventricular tachycardias in the young: An international multicenter study

Kathryn K. Collins, Michael S. Schaffer, Leonardo Liberman, Elizabeth Saarel, Maria Knecht, Ronn E. Tanel, David Bradley, Anne M. Dubin, Thomas Paul, Jack Salerno, Yaniv Bar-Cohen, Narayanswami Sreeram, Shubhayan Sanatani, Ian H. Law, Andrew Blaufox, Anjan Batra, Jose M. Moltedo, George F. Van Hare, John Reed, Pamela S. RoJohn Dale Kugler, Chris Anderson, John K. Triedman

Research output: Contribution to journalArticle

32 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)640-648
Number of pages9
JournalJournal of Cardiovascular Electrophysiology
Volume24
Issue number6
DOIs
StatePublished - Jun 1 2013

Fingerprint

Ventricular Tachycardia
Multicenter Studies
Pediatrics
Tachycardia
Recurrence
Intention to Treat Analysis
Catheter Ablation
Calcium Channel Blockers
Adenosine
Cardiac Arrhythmias

Keywords

  • cryoablation
  • fascicular tachycardia
  • idiopathic ventricular tachycardia
  • pediatrics
  • radiofrequency ablation
  • ventricular tachycardia
  • verapamil-sensitive VT

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Collins, K. K., Schaffer, M. S., Liberman, L., Saarel, E., Knecht, M., Tanel, R. E., ... Triedman, J. K. (2013). Fascicular and nonfascicular left ventricular tachycardias in the young: An international multicenter study. Journal of Cardiovascular Electrophysiology, 24(6), 640-648. https://doi.org/10.1111/jce.12105

Fascicular and nonfascicular left ventricular tachycardias in the young : An international multicenter study. / Collins, Kathryn K.; Schaffer, Michael S.; Liberman, Leonardo; Saarel, Elizabeth; Knecht, Maria; Tanel, Ronn E.; Bradley, David; Dubin, Anne M.; Paul, Thomas; Salerno, Jack; Bar-Cohen, Yaniv; Sreeram, Narayanswami; Sanatani, Shubhayan; Law, Ian H.; Blaufox, Andrew; Batra, Anjan; Moltedo, Jose M.; Van Hare, George F.; Reed, John; Ro, Pamela S.; Kugler, John Dale; Anderson, Chris; Triedman, John K.

In: Journal of Cardiovascular Electrophysiology, Vol. 24, No. 6, 01.06.2013, p. 640-648.

Research output: Contribution to journalArticle

Collins, KK, Schaffer, MS, Liberman, L, Saarel, E, Knecht, M, Tanel, RE, Bradley, D, Dubin, AM, Paul, T, Salerno, J, Bar-Cohen, Y, Sreeram, N, Sanatani, S, Law, IH, Blaufox, A, Batra, A, Moltedo, JM, Van Hare, GF, Reed, J, Ro, PS, Kugler, JD, Anderson, C & Triedman, JK 2013, 'Fascicular and nonfascicular left ventricular tachycardias in the young: An international multicenter study', Journal of Cardiovascular Electrophysiology, vol. 24, no. 6, pp. 640-648. https://doi.org/10.1111/jce.12105
Collins, Kathryn K. ; Schaffer, Michael S. ; Liberman, Leonardo ; Saarel, Elizabeth ; Knecht, Maria ; Tanel, Ronn E. ; Bradley, David ; Dubin, Anne M. ; Paul, Thomas ; Salerno, Jack ; Bar-Cohen, Yaniv ; Sreeram, Narayanswami ; Sanatani, Shubhayan ; Law, Ian H. ; Blaufox, Andrew ; Batra, Anjan ; Moltedo, Jose M. ; Van Hare, George F. ; Reed, John ; Ro, Pamela S. ; Kugler, John Dale ; Anderson, Chris ; Triedman, John K. / Fascicular and nonfascicular left ventricular tachycardias in the young : An international multicenter study. In: Journal of Cardiovascular Electrophysiology. 2013 ; Vol. 24, No. 6. pp. 640-648.
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abstract = "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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AU - Saarel, Elizabeth

AU - Knecht, Maria

AU - Tanel, Ronn E.

AU - Bradley, David

AU - Dubin, Anne M.

AU - Paul, Thomas

AU - Salerno, Jack

AU - Bar-Cohen, Yaniv

AU - Sreeram, Narayanswami

AU - Sanatani, Shubhayan

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AU - Blaufox, Andrew

AU - Batra, Anjan

AU - Moltedo, Jose M.

AU - Van Hare, George F.

AU - Reed, John

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N2 - 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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KW - cryoablation

KW - fascicular tachycardia

KW - idiopathic ventricular tachycardia

KW - pediatrics

KW - radiofrequency ablation

KW - ventricular tachycardia

KW - verapamil-sensitive VT

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