Idiopathic sustained left ventricular tachycardia in pediatric patients

Background: Idiopathic sustained ventricular tachycardia originating from t he left ventricle (ILVT) has been an indication for catheter ablation. The present study evaluated the clinical features, long-term prognosis and indi cations for treatment in pediatric patients with ILVT. Methods: The subjects of the present study were eight patients (four males and four females) with a mean age at onset of 11.0 years (range 3-15 years) . The mean follow-up period was 7.7 years (range 2.1-11.3 years). Results: In electrophysiologic studies, intravenously administered verapami l was effective for the termination of tachycardia in all six patients who received this treatment and for the prevention of tachycardia in four of fi ve patients. Oral administration of verapamil was effective in five of seve n patients. Propranolol or flecainide was added to the treatment protocol f or two patients who did not respond to verapamil alone. Tachycardia disappe ared without drugs in four patients during the follow-up period and became non-sustained in another patient. Two of three patients with persistent tac hycardia underwent catheter ablation. Pharmacologic treatment was very effe ctive for ILVT among these patients. Conclusions: Pharmacologic therapy, such as with verapamil, is still the tr eatment of choice for ILVT because of a good long-term prognosis and potent ial risks and complications by manipulation of catheter ablation.