Document Detail


Frequency of cardiac death in children with idiopathic dilated cardiomyopathy.
MedLine Citation:
PMID:  19932795     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The prognosis in children with idiopathic dilated cardiomyopathy (IDC) is guarded, with the 5-year mortality rate ranging from 14% to 50%, owing to sudden cardiac death (SCD) or pump failure. The risk factors for SCD in adults with IDC include asymptomatic nonsustained ventricular tachycardia and poor left ventricular function. It is unclear whether these findings can be extrapolated to the pediatric population. A retrospective review of all patients with the diagnosis of IDC seen at a single institution from 1990 to 2004 was performed. A total of 85 patients (46 males), with a median age of 3.8 years (0 days to 17.3 years) were studied. The mean left ventricular ejection fraction was 25 +/- 12% (median 23%, range 45% to 45%) at presentation. The following arrhythmias occurred at presentation or during the initial hospitalization: nonsustained ventricular tachycardia in 6, sustained ventricular tachycardia or fibrillation in 1, supraventricular arrhythmias in 6, and both atrial and ventricular arrhythmias in 1. During a subsequent hospitalization or outpatient follow-up, 7 patients had the following arrhythmias: supraventricular arrhythmias in 2, nonsustained ventricular tachycardia in 4, and both atrial and ventricular arrhythmias in 1. The cumulative survival rate was 40% at a mean follow-up of 6.2 years (95% confidence interval 4.4 to 8.1). One single episode of SCD occurred in 1 patient without a history of sustained arrhythmias. In conclusion, in children with IDC, despite the low left ventricular ejection fraction and presence of ventricular arrhythmias, only one episode of SCD occurred in this group of patients. Given the 1% incidence of SCD in this cohort, the use of implantable cardioverter-defibrillators as primary prevention in children with IDC might not be indicated.
Authors:
V Vivian Dimas; Susan W Denfield; Richard A Friedman; Bryan C Cannon; Jeffrey J Kim; E O 'brian Smith; Sarah K Clunie; Jack F Price; Jeffrey A Towbin; William J Dreyer; Naomi J Kertesz
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Publication Detail:
Type:  Journal Article     Date:  2009-10-14
Journal Detail:
Title:  The American journal of cardiology     Volume:  104     ISSN:  1879-1913     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2009 Dec 
Date Detail:
Created Date:  2009-11-25     Completed Date:  2010-02-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1574-7     Citation Subset:  AIM; IM    
Affiliation:
Department of Pediatrics, Division of Cardiology, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Arrhythmias, Cardiac / mortality
Cardiomyopathy, Dilated / diagnosis,  epidemiology,  mortality*
Child
Child, Preschool
Death, Sudden, Cardiac / epidemiology*,  prevention & control
Female
Follow-Up Studies
Humans
Incidence
Infant
Infant, Newborn
Male
Medical Records
Prognosis
Retrospective Studies
Risk Factors
Severity of Illness Index
Survival Rate
Texas / epidemiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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