Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Pediatrics

Background: Ventricular arrhythmia may be an isolated benign finding in children, a marker of serious systemic disease or myopathy or a mechanism for syncope and sudden cardiac death. Arrhythmogenic right ventricular dysplasia (ARVD) is an inherited cardiomyopathy disorder, leading to arrhythmias, and predominantly involving the right ventricular myocardium. Aim of the work: Evaluation of pediatric patients with ventricular arrhythmias for presence of systemic disease and detection of cardiac abnormalities that could not be detected by routine echocardiography using cardiac magnetic resonance imaging (CMR) in children with a structurally normal heart. Methodology: Twenty one cases of ventricular arrhythmias with a structurally normal heart were included. We studied the clinical picture, 12 leads ECG with measurement of {QRS duration, QTc, QTc dispersion, JTc, JTc dispersion, T (p-e) and T (p-e)/QT}, 24 hours Holter monitoring, Echocardiography and CMR for selected cases. Results: Palpitation was the presenting symptom in 66.6% of the cases and syncope in 23.8%. Ventricular arrhythmias were of right ventricular origin in 95.2% of the cases, polymorphic in 61.9%. QTc dispersion and JTc dispersion were statistically significant higher in cases with chest pain (P value 0.001). Holter detected ventricular arrhythmias frequency ranged from (4-47%).One case was diagnosed as Wilson disease. No cardiac abnormalities were detected in CMR. Medical management was indicated in 16 cases (76%)

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