Prognosis in Primary Ventricular Tachycardia in the Pediatric Patient

Five male pediatric patients with primary ventricular tachycardia are described. Although three were initially in congestive heart failure due to the tachycardia and were extremely difficult to manage, all have completely recovered, are not taking medication, and are free of arrhythmia. Three of the patients required long-term management with quinidine, with a therapeutic goal of controlling the heart rather than abolishing the arrhythmia. No growth disturbances were found in those three patients. A review of reported cases revealed 71 infants and children with ventricular tachycardia not associated with heart disease or systemic disorders; only four deaths were reported (5.6%). In the primary form of ventricular tachycardia in children, complete pharmacologic suppression may not be achieved without seriously endangering the normal electrophysiologic functions. Controlling the rate to an asymptomatic level with pharmacologic means is safer for a problem that may be self-limited.