Rvot vt

[yvie110]

Hello,
        My husband was diagnosed with rvot vt in his early 30's and has had a successful ablation.  My 10 year old son has had episodes of palpitations sometimes with headache, lightheadedness and nausea.  He has had a normal echo and ekg.  We have tried to capture them on a monitor but have been unsuccessful.  He had one at school that he felt dizzy sweaty and his heart rate was 120- 140 a few days ago.  On advise from Pedi took him to ER it had stopped by the time we arrived and we were sent home.  We have been told that in light of normal echo and ekg that it is probably ok.  Great but is there any familial Rvot vt or can this occur in children.  Do I continue to worry and react ( calling Pedi ) every time he tells me his heart hurts and is beating to fast?  I am frustrated, I don't want to worry my son unnecessarily but I don't want under react either.  Any input would be helpful.
Thank You  

[tickertock]

Who told you EF of 55% is not great or not that bad. This is misleading as far as I'm concerned 55% is normal "normal is normal" Different centers has different EF values some has 50-75% as normal , other 55-70% give or take 5%. I had an echo in 2001 and on the same echo the EF varied between 64-75%, another in 2005, that one varied between 53-63% which the doctor called 55% and I was told that was completely normal.

[yvie110]

Thanks for your input.  I have another question.  My husbands lv ef is about 55% which I have been told is not great but not that bad either.  So here is the question, In a person who has had multiple arrhythmias in his life (until the ablation) does this have an effect on lv function?  My second concern is if RVOT VT is not genetic but you have a predisposition and with my husband his became much worse as time went on and states he had experiences as a child of his heart beating to fast.  If this can be a possibility of what my son is experiencing and as time goes on the symptoms progress as with my husband.  Maybe I am just over thinking.  But I would think it would be better to be proactive if having arrhythmias can effect your heart's ability to pump efficiently.  If the event monitor fails to capture as it has in past because of the infrequency of my son's episodes should we keep it in the back of our minds that this maybe RVOT VT?

[Michael J. McWilliams, M.D.]

Great question.

There is not a "gene" that causes RVOT VT yet, but it is possible that you can be predisposed to this.  The good news about RVOT VT is that it is not like the dangerous VTs that you read about on the internet and the prognosis with RVOT VT is the same as the general population.  I know it does not seem reassuring that he has a normal heart if he is still having the symptoms -- but this should at least make you feel that he is not at risk from dying from an arrhythmia.  this is one of the most common unspoken concerns.

The question is how often are the events. If they occur monthly, I would use an event monitor and teach your son to press the button when the fast heart rates happen.  That will help you get a recording of the event.  If the events happen with exercise or other precipitating events, I would try to recreate those triggers while he is wearing the monitor.  

There are pediatic electrophysiologists out there that might be able to assist with the work up and evaluation.  Most academic centers have pediatric electrophysiologists.  It might be worth talking on one to help figure out what is going on.  Ask your pediatrician for a referral or do some research and self refer if your insurance will allow you.  You may feel more relaxed about this when you see a doctor that deals with these issues everyday.  As parent, I can understand your concerns.

I hope this helps and thanks for posting.