Cardiac magnetic resonance of healthy children and young adults with frequent premature ventricular complexes

OBJECTIVE: To assess whether magnetic resonance imaging could detect any cardiac morphological or functional myocardial alterations in healthy children and young adults with ventricular arrhythmias. METHODS: Twenty-three subjects (14 male, mean age 15.6 +/- 6.5 years) with frequent (> or =30/h) premature ventricular complexes (PVCs) on Holter monitoring and normal echocardiographic and electrocardiographic findings underwent cardiac magnetic resonance (CMR) on a 1.5T scanner and an exercise stress test. Subjects were also followed up for a period of 71 +/- 24 months. RESULTS: CMR showed no evidence of structural cardiac abnormalities, but functional assessment revealed significant impairment in 17 subjects (74%): mild to moderate right ventricular enlargement was found in all of these subjects associated with a mild reduction of ventricular function in five cases (22%) and mild free wall and/or apex contraction abnormalities in eight subjects (35%). PVCs persisted during stress test in three subjects (13%) and disappeared in 19 (83%). No serious cardiac event was observed during the follow-up. CONCLUSIONS: Our study shows that subjects with PVCs without detectable electrocardiographic and echocardiographic abnormalities frequently exhibit functional impairment of the right ventricle at CMR, potentially responsible for ventricular arrhythmias. Although the causes of these abnormalities remain to be elucidated, the long-term outcome of these subjects is excellent.