13yr with sustained V-tach

[Laticia_am_i]

I am needing as much information or personal advise as possible.
My 13yr old, very healthy and athletic son called me the other day stating that his heart was racing. We live in a very rural community so I took him to the EMT office where they took his pulse and BP.  BP normal to low normal and heart rate 220bmp.  They advised me to take him into the dr. office.  After going to the dr. office, then the nearest hospital via ambulance he was finally transferred to OKC-OU children's hospital by medi-flight.  He was diagnosed with sustained v-tach in the left ventricle.  Because his blood pressure was good, no chest pain, dizziness, or shortness of breath, he was left in the v-tach state for 12 hours so that EKG's and echo tests could be ran to correctly figure out what type it was and where it was located at.  He is currently on a calcium blocker and has been on an event heart monitor for the last 30 days, in which he has not had any other attacks of the tachycardia.  The drs have restricted his activity to nothing (no sports, no roller coasters or rides, nothing that would raise his heart rate), which I understand but he is having a very hard time with.  We had our follow-up appointment yesterday and discussed the possibility of an ablation procedure.  My son would do it tomorrow if it meant he could resume his normal life afterwards however the dr. warned us that with the location and type of arrthymia that he has, that it was very possible for them to get into surgery and not be able to trigger the arrthymia or v-tach again.  After reading some of the post on here, I am very concerned about this possibility.  
So my questions are:
1)  Anybody have a child or is a young adult with this condition and what treatment plan did you follow?
2)  Anybody have a successful ablation for v-tach in the left ventricle?
3)  What are the long term side effects of the ablation procedure?
4)  If it was your child, what would you do?  ablation or medication?

Thank you for your time

[Laticia_am_i]

Thank you so much for your reply!!

Because all of this is new to me, I am not sure I know the answers and I know all of the correct terminology to use.....but I will try.

From what I understand they basically did the EP study while he was in his arrhythmia...in the ICU.  They were unable to diagnosis him until they placed an electrode down his nose and throat and were able to see the backside of his heart.  I believe that they gave him a dose of 6mg and 12mg of Adenocard on the medi-flight and then another round in the ICU while they were doing the EP study, which basically told them that it wasn't SVT.  It was procainamide that broke the arrhythmia and he went back into the normal rate.

From what the dr. said yesterday they feel like it (the spot of dysfunction) is located on the back wall of the left ventricle...if that makes sense.  The dr. also said that this type is very rare (especially in young healthy individuals) and its hard to trigger or predict so he might could play sports and never have another one or might be sitting in class and have an episode....who knows!!  But typically things like adrenaline or stressing your heart during sports can trigger them so better be safe than sorry.  

I know that his echo was good...no abnormalities but I don't think they told me anything about his resting EKG.  I will ask.  

I think more than anything I am looking for information and what other people have experienced.  I am trying to compile a list of questions to have answered before we make our final decision.  Thank so for your help and I will try and post a revised copy in the expert section and see what information I can gather there.
THANKS AGAIN

[is_something_wrong]

Hello.

I'm really sorry this happened to him.

You've asked this question in the heart rhythm medical community, and unfortunately there are likely no doctors here to answer your question (I know that a few of them sign up here as community members, but that's uncommon and I haven't seen them for a long time.) Your question is complicated and I think it should be answered by a medical professional, which I'm unfortunately not.

I have some thoughts, but I wouldn't make any decisions based on them.

Sustained VT in young boys (as far as I know) usually origin from the right ventricle, but it may also origin from the left fascicle in the left ventricle, though more uncommon. I think they still are fairly benign considering the risk of degrading to ventricular fibrillation, but this is of course a detail you need to ask a cardiologist or electrophysiologist.

If activities / sports are restricted, there is a reason to believe the doctors think adrenaline is a trigger. There are a few conditions where adrenaline may provoke VT, some of them benign, but one of them is inherited and dangerous, but that would present with runs of polymorphic VT (usually from the right ventricle), which is not the case here, and it would not be tolerated so well. I guess that's ruled out here. I guess his resting EKG and echocardiography didn't reveal any abnormalities.

I hope the doctors informed you if the prognosis is serious or not.

I can't answer your specific questions, but I guess it's not acceptable for a young boy to not be able to have an active lifestyle. Which means something must be done. An EP study is as far as I know a low risk procedure. If the EP study fails, and doctors are still unable to find a cause, I think there is a possibility to implant an ICD.

Please keep us updated, and good luck to both of you.