The Prognosis And Relative Factors Of Premature Ventricular Contractios In Children

Objective:To investigate the prognosis and relative factors of prematureventricular contraction (PVC) in children, for better management andestimation of PVC prognosis.Methods:All the cases were diagnosed with PVC by dynamicelectrocardiogram (DCG) in Children’s Hospital of Chongqing MedicalUniversity from January2008to December2013. All cases were dividedinto the left ventricle and right ventricle types based on the QRSmorphology on body surface electrocardiogram. On the other hand, allcases were divided into daytime, night and mixed types according to thetime of PVC appeared on the DCG. And all cases were divided into P-PVC,N-PVC, and I-PVC groups by the relationship between hourly PVC andaverage HR. All the cases were followed up with dynamicelectrocardiogram every half a year to one year. All datum wereretrospectively assessed. Results:1.Total101cases with PVC diagnosed in Children’s Hospital ofChongqing Medical University from January2008to December2013.There were51cases male and50cases female. Aged from5moth to14years, averaged6.59±3.52years. Accroding to the types and groups,there were33cases left ventricle group and68cases right ventricle group.34cases daytime type,20cases night type, and47cases mixed. P-PVC44cases, N-PVC22cases, I-PVC37cases.2.The follow-up data showed that when followed up for3months,42cases (77.78%) with improvement or better orientation; followed up for6months,51cases (85.00%) with improvement or better orientation;followed up for1year,28cases (71.79%) with better or better orientation;followed up for2years,36cases (77.78%) with better or betterorientation.3.Relationship between origin position and prognosis of PVC: Datasimplied that PVC located in right ventricular showed better prognosis thanthat of located in left ventricular. The case in improving or betterorientation tend to be29cases (78.39%), left ventricular type for13cases(76.47%); followed up for6months, the case in better or better orientationof32cases (88.89%), left ventricular type for19cases (79.17%);Followed up for1year, that showed improved or better orientation20cases (76.92%), left ventricular type8cases (61.53%). Followed up2 years, that showed improved or better orientation29cases (85.29%), leftventricular type for7cases (58.33%). At all time follow-up that PVC datashowed that between left ventricular and right ventricular in improvingtrend rate, there was no statistically significant difference (p>0.05).4. Relationship between circadian rhythms and prognosis of PVC:Data showed that when followed up for3months, cases that showed betteror improve tended were daytime type18cases (64.29%), mixed type andnight (non-daytime type) for24cases (75.00%); followed up for6monthsthe daytime showed better or improve orientation in22cases (78.57%),non-daytime for29cases (90.62%); followed up for1year, Day typebetter or improve orientation in13cases (65.00%), non-daytime for23cases (88.46%); Follow-up2years, daytime type showed better orimprove tended to8cases (57.14%), non-daytime for20cases (80.00%).In the time of6months follow-up data showed that that between daytimeand non-daytime type in improving trend rate, it showed statisticallysignificant difference (p<0.05). While at other times of follow-up datawere no statistical difference (p>0.05).5.Relationship between average HR (Heart Rate) and prognosis ofPVC: Data showed that when followed up for3months, cases that showedbetter or improve tended were P-PVC16cases (72.73%), N-PVC andI-PVC for26patients (81.25%). When followed up for6months casesthat showed better or improve tended were P-PVC21cases (75.00%), N-PVC and I-PVC for30patients (93.75%); Follow-up of1year casesthat showed better or improve tended were P-PVC15cases (71.43%),N-PVC and I-PVC for21cases (84.00%). Follow-up2years that showedbetter or improve tended were P-PVC13cases (65.00%), N-PVC andI-PVC for15cases (71.77%). In the time of6months follow-up datashowed that that between P-PVC and non-P-PVC type in improving trendrate, it showed statistically significant difference (p<0.05). While at othertimes of follow-up data were no statistical difference (p>0.05).Conclusion：1. There are no significant difference between right and leftventricular origin of ventricular premature contraction, the origin positionare not to be used as the basis for judging clinical prognosis of ventricularpremature beat.2. Non prognosis of daytime prognosis is better than the daytime type,the prognosis of P-PVC is better than the N-PVC and I-PVC. Thecircadian rhythm and correlation with HR of ventricular premature beatcould be used as the basis for judging clinical prognosis of ventricularpremature beat.3. The children how good long-term prognosis of idiopathicventricular premature beat, but the daytime premature beat and positivelyrelated to tend to be more sympathetic premature ventricular prematurebeat, or organic tendency may be premature, should be given more clinical attaches great importance to, to determine whether early clinicalintervention on ventricular premature beat.