Advertisement

Pediatric Cardiology

, Volume 16, Issue 2, pp 56–60 | Cite as

Cardiac dysrhythmias in children with idiopathic dilated or hypertrophic cardiomyopathy

  • G. Müller
  • H. E. Ulmer
  • K. J. Hagel
  • D. Wolf
Original Articles

Abstract

To assess the incidence and prognostic significance of cardiac dysrhythmias in children with idiopathic dilated or hypertrophic cardiomyopathy, the clinical course of 59 patients was retrospectively reviewed over a period of 27 years. Dilated cardiomyopathy (DCM) was diagnosed in 28 patients and hypertrophic cardiomyopathy (HCM) in 31 patients. The mean age at the time of diagnosis was 2.8±0.7 years in DCM patients and 6.7±0.8 years in HCM patients. Mean follow-up time after diagnosis of cardiomyopathy was 4.1±1.0 years in DCM patients and 6.6±0.8 years in HCM patients. Clinically significant cardiac dysrhythmias were found in 17 of 59 patients (29%): 7 of 28 patients (25%) with DCM and 10 of 31 patients (32%) with HCM. The initial diagnosis of a cardiac dysrhythmia was made by standard electrocardiography in 12 of 17 patients (71%) and by 24-hour Holter monitoring in 5 of 17 patients (29%). Ventricular dysrhythmias were present in 5 of 7 patients with dilated cardiomyopathy and in 5 of 10 patients with hypertrophic cardiomyopathy. During the follow-up time, death occurred in 18 of 59 patients (31%): 8 of 59 patients (14%) died from congestive heart failure and 10 of 59 patients (17%) died suddenly. Among the sudden deaths were 4 of 28 patients (14%) with dilated cardiomyopathy and 6 of 31 patients (19%) with hypertrophic cardiomyopathy. Cardiac dysrhythmias had been documented in 6 of the 10 patients dying suddenly (3 of 4 patients with DCM and 3 of 6 patients with HCM). It is concluded that (1) cardiac dysrhythmias are not a rare finding in children with idiopathic dilated or hypertrophic cardiomyopathy, and (2) their occurrence is not a predictor for sudden death.

Key Words

Idiopathic cardiomyopathy Cardiac dysrhythmias Sudden cardiac death 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Brandenburg RO, Chazov E, Cherian G, et al (1981) Report on the WHO/ISFC Task Force on definition and classification of cardiomyopathies.Circulation 64:437A-438AGoogle Scholar
  2. 2.
    Chen SC, Nouris S, Balfour I, Jureidini S, Appleton RS (1990) Clinical profile of congestive cardiomyopathy in children.J Am Coll Cardiol 15:189–193Google Scholar
  3. 3.
    Dunnigan A, Staley NA, Smith SA, et al (1987) Cardiac and skeletal muscle abnormalities in cardiomyopathy: comparison of patients with ventricular tachycardia or congestive heart failure.J Am Coll Cardiol 10:608–618Google Scholar
  4. 4.
    Friedman RA, Moak JP, Garson A Jr (1991) Clinical course of idiopathic dilated cardiomyopathy in children.J Am Coll Cardiol 18:152–156Google Scholar
  5. 5.
    Goodwin JF (1982) The frontiers of cardiomyopathy.Br Heart J 48:1–18Google Scholar
  6. 6.
    Griffin ML, Hernandez A, Martin TC et al (1988) Dilated cardiomyopathy in infants and children.J Am Coll Cardiol 11:139–144Google Scholar
  7. 7.
    Klitzner TS (1990) Sudden cardiac death in children.Circulation 82:629–632Google Scholar
  8. 8.
    Kron J, Hart M, Schual-Berke S, et al (1988) Idiopathic dilated cardiomyopathy: role of programmed electrical stimulation and Holter monitoring in predicting those at risk of sudden death.Chest 93:85–90Google Scholar
  9. 9.
    Kron J, Oliver RP, Norsted S, Silka M (1990) The automatic implantable cardioverter-defibrillator in young patients.J Am Coll Cardiol 16:896–902Google Scholar
  10. 10.
    Lewis AB, Chabot M (1991) Outcome of infants and children with dilated cardiomyopathy.Am J Cardiol 68:365–369Google Scholar
  11. 11.
    Maron BJ, Fananapazir L (1992) Sudden cardiac death in hypertrophic cardiomyopathy.Circulation 85 (Suppl I):252–257Google Scholar
  12. 12.
    Maron BJ, Roberts WC, Epstein SE (1982) Sudden death in hypertrophic cardiomyopathy: a profile of 78 patients.Circulation 65:1388–1394Google Scholar
  13. 13.
    Maron BJ, Savage DD, Wolfson JK, Epstein SE (1981) Prognostic significance of 24 hour ambulatory electrocardiographic monitoring in patients with hypertrophic cardiomyopathy: a prospective study.J Am Coll Cardiol 48:252–257Google Scholar
  14. 14.
    McKenna WJ, Franklin RCG, Nihoyannopoulos P, et al (1988) Arrhythmia and prognosis in infants, children and adolescents with hypertrophic cardiomyopathy.J Am Coll Cardiol 11:147–153Google Scholar
  15. 15.
    Meinertz T, Kasper W, Hofmann T, et al (1983) Häufigkeit und klinische Bedeutung ventrikulärer Herzrhythmusstörungen bei dilatativer Kardiomyopathie.Dtsch Med Wochenschr 108:443–448Google Scholar
  16. 16.
    Neri R, Mestroni L, Salvi A, Pandullo C, Camerini F (1987) Ventricular arrhythmias in dilated cardiomyopathy: efficacy of amiodarone.Am Heart J 113:707–715Google Scholar
  17. 17.
    Nestico PF, Morganroth J (1988) Congestive heart failure and ventricular arrhythmias. In: Shaver JA, Brest AN (eds)Cardiomyopathies: Clinical Presentation, Differential Diagnosis, and Management. Davis, Philadelphia, pp 253–262Google Scholar
  18. 18.
    Olshausen KV, Stienen U, Schwarz F, Kübler W, Meyer J (1988) Long-term prognostic significance of ventricular arrhythmias in idiopathic dilated cardiomyopathy.Am J Cardiol 61:146–151Google Scholar
  19. 19.
    Robinson K, Frenneaux MP, Stockings B, et al (1990) Atrial fibrilation in hypertrophic cardiomyopathy: a longitudinal study.J Am Coll Cardiol 15:1279–1285Google Scholar
  20. 20.
    Spirito P, Watson RM, Maron BJ (1987) Relation between extent of left ventricular hypertrophy and occurrence of ventricular tachycardia in hypertrophic cardiomyopathy.Am J Cardiol 60:1137–1142Google Scholar
  21. 21.
    Stafford WJ, Trohman RG, Bilsker M, et al (1986) Cardiac arrest in an adolescent with atrial fibrillation and hypertrophic cardiomyopathy.J Am Coll Cardiol 7:701–704Google Scholar

Copyright information

© Springer-Verlag New York Inc. 1995

Authors and Affiliations

  • G. Müller
    • 1
  • H. E. Ulmer
    • 1
  • K. J. Hagel
    • 2
  • D. Wolf
    • 1
  1. 1.Abteilung KinderkardiologieUniversitätskinderklinikHeidelbergGermany
  2. 2.Abteilung KinderkardiologieUniversitätskinderklinikGiessenGermany

Personalised recommendations