TY - JOUR T1 - Evaluation of the Clinical Phenotype and Follow-up of Children with ‘Nonsustained’ Ventricular Tachycardia Detected on 24-hour Rhythm Holter AU - Karaca, Serra AU - Özbingöl, Doruk AU - Öztarhan, Kazım AU - Nişli, Kemal PY - 2025 DA - February Y2 - 2024 DO - 10.26650/jchild.2024.1588249 JF - Çocuk Dergisi PB - İstanbul Üniversitesi WT - DergiPark SN - 1308-8491 SP - 241 EP - 244 VL - 24 IS - 4 LA - en AB - Objective: Non-sustained ventricular tachycardia (NSVT) is an important arrhythmic finding in pediatric patients, with varying clinical implications based on the presence of structural heart disease. This study aimed to evaluate the clinical characteristics, follow-up, and management of children diagnosed with NSVT detected on 24-hour Holter monitoring.Methods: A retrospective analysis was conducted on 22 pediatric patients (9 males, 13 females) aged 2.5–17 years, who were diagnosed with NSVT between 2015 and 2023. Patients with sustained VT, channelopathies, or electrolyte-related prolonged QTc were excluded. Echocardiography, electrocardiography, and Holter monitoring were performed for all patients. Statistical analyses were conducted using SPSS 26.0, with significance set at p<0.05.Results: Monomorphic NSVT was observed in 14 patients (64%), while polymorphic NSVT was found in 8 patients (36%). The mean VT rate was 161.2±18.7 bpm, with polymorphic VT demonstrating a significantly higher rate (175.3±4.4 bpm) than monomorphic VT (153.3±4.6 bpm) (p=0.003). The prematurity index was significantly lower in polymorphic VT (0.75±0.03) than in monomorphic VT (1.1±0.03) (p<0.001). Additionally, QTc was longer in polymorphic VT (463.5±5.1 ms vs. 425.4±6.5 ms, p=0.004). Structural heart disease was present in 50% of cases, with polymorphic VT being predominantly associated with cardiomyopathies (dilated, hypertrophic, and non-compaction). Only three patients (14%) were symptomatic, and all symptomatic patients had structural heart disease. All patients with underlying cardiac abnormalities were treated with beta-blockers, primarily propranolol, while those with normal echocardiography were followed without medication. No adverse effects, syncope, or mortality were observed during follow-up.Conclusion: NSVT in pediatric patients should be carefully evaluated, particularly in the presence of structural heart disease. While monomorphic NSVT in structurally normal hearts appears benign, polymorphic NSVT is strongly associated with cardiomyopathies, necessitating medical therapy and close monitoring. Individualized management based on echocardiographic findings and arrhythmic characteristics is essential for optimizing patient outcomes. KW - Non-sustained ventricular tachycardia KW - Holter monitoring KW - beta-blockers CR - Whitaker J, Wright MJ, Tedrow U. Diagnosis and management of ventricular tachycardia. 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Advancements in the diagnosis and management of premature ventricular contractions in pediatric patients. Front Pediatr. 2024;12:1373772. google scholar UR - https://doi.org/10.26650/jchild.2024.1588249 L1 - https://dergipark.org.tr/tr/download/article-file/4379761 ER -