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Ventricular Dysrhythmias in Children With Marfan's Syndrome FREE

Su-chiung Chen, MD; Leonard F. Fagan, MD; Soraya Nouri, MB, BS; James L. Donahoe, MD
[+] Author Affiliations

Reprint requests to Cardinal Glennon Memorial Hospital for Children, 1465 S Grand Blvd, St Louis, MO 63104 (Dr Chen).


Am J Dis Child. 1985;139(3):273-276. doi:10.1001/archpedi.1985.02140050067024.
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• A teenager with Marfan's syndrome required resuscitation and was found to have multiform premature ventricular contractions and ventricular tachycardia. Of 24 children with Marfan's syndrome, eight (33.3%) were found to have ventricular dysrhythmias, including three with ventricular tachycardia. Six of these eight patients had mitral valve prolapse, and five had prolonged QT or QTU intervals corrected for heart rate. However, only two patients had severe mitral regurgitation, five had only mild heart disease, and one had no detectable heart lesion. The role of mitral valve prolapse and/or delayed repolarization in the development of ventricular dysrhythmia was explored. Delayed repolarization, especially when combined with mitral valve prolapse, is associated with occurrence of ventricular dysrhythmia. Serious ventricular dysrhythmia can occur in children with Marfan's syndrome with or without substantial valve disease, and the dysrhythmia appears to progress with age.

(AJDC 1985;139:273-276)

REFERENCES

Bowers D:  The electrocardiogram in Marfan's syndrome . Am J Cardiol 1961;;7:661-672.
Link to Article
Phornphutkul C, Rosenthal A, Nadas AS:  Cardiac manifestations of Marfan syndrome in infancy and childhood . Circulation 1973;;47:587-596.
Link to Article
Pyeritz RE, McKusick VA:  The Marfan syndrome: Diagnosis and management . N Engl J Med 1979;;300:772-777.
Link to Article
McKusick VA: Heritable Disorders of Connective Tissue , ed 4. St Louis, CV Mosby Co, 1972;, pp 61-223.
Boucek RJ, Noble NL, Gunja-Smith Z, et al:  The Marfan syndrome: A deficiency in chemically stable collagen cross-links . N Engl J Med 1981;;305:988-991.
Link to Article
Pyeritz RE, Wappel MA:  Mitral valve dysfunction in Marfan syndrome . Am J Med 1983;;74:797-807.
Link to Article
Swartz MH, Teichholz LE, Donoso E:  Mitral valve prolapse: A review of associated arrhythmias . Am J Med 1977;;62:377-389.
Link to Article
Pickoff AS, Gelband H, Ferrar P, et al:  Premature ventricular contractions as the presenting feature of mitral valve prolapse in children . J Pediatr 1979;;94:615-617.
Link to Article
Kavey RW, Sondheimer HM, Blackman MS:  Detection of dysrhythmia in pediatric patients with mitral valve prolapse . Circulation 1980;;62: 582-587.
Link to Article
Moss AJ, Schwartz PJ:  Delayed repolarization (QT or QTU prolongation) and malignant ventricular arrhythmias . Mod Concepts Cardiovasc Dis 1982;;51:85-90.
Bekheit S, Ali A:  QT interval in idiopathic prolapsed mitral valve . Am J Cardiol 1978;;41: 374.
Link to Article
Puddu PE, Pasternac A, Tubau JF, et al:  QT interval prolongation and increased plasma catecholamine levels in patients with mitral valve prolapse . Am Heart J 1983;;105:422-428.
Link to Article
Soffer J, Dreifus LS, Michelson EL:  Polymorphous ventricular tachycardia associated with normal and long QT intervals . Am J Cardiol 1982;;49:2021-2029.
Link to Article
Wellens HJJ:  Value and limitations of programmed electrical stimulation of the heart in the study and treatment of tachycardias . Circulation 1978;;57:845-853.
Link to Article
Evans TR, Curry PVL, Fitchett DH, et al:  'Torsade de pointes' initiated by electrical ventricular stimulation . J Electrocardiol 1976;;9:255-258.
Link to Article
Horowitz LN, Greenspan AM, Spelman SR, et al:  Torsades de pointes: Electrophysiologic studies in patients without transient pharmacologic or metabolic abnormalities . Circulation 1981;;63:1120-1128.
Link to Article
Brugada P, Heddle B, Wellens HJJ:  Results of a ventricular stimulation protocol using a maximum of four premature stimuli in patients without documented or suspected ventricular arrhythmias . Circulation 1982;;66( (suppl 2) ):79.
Link to Article
El-Sherif N, Mehra R, Gough WB, et al:  Reentrant ventricular arrhythmias in late myocardial infarction period: II. Burst pacing versus multiple premature stimulation in the induction of reentry . J Am Coll Cardiol 1984;;4:295-304.
Link to Article
Akhtar M:  Clinical application of rapid ventricular burst pacing versus extra stimulation for induction of ventricular tachycardia . J Am Coll Cardiol 1984;;4:305-307.
Link to Article
James TN, Frame B, Schatz IJ:  Pathology of cardiac conduction system in Marfan syndrome . Arch Intern Med 1964;;114:339-343.
Link to Article

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References

Bowers D:  The electrocardiogram in Marfan's syndrome . Am J Cardiol 1961;;7:661-672.
Link to Article
Phornphutkul C, Rosenthal A, Nadas AS:  Cardiac manifestations of Marfan syndrome in infancy and childhood . Circulation 1973;;47:587-596.
Link to Article
Pyeritz RE, McKusick VA:  The Marfan syndrome: Diagnosis and management . N Engl J Med 1979;;300:772-777.
Link to Article
McKusick VA: Heritable Disorders of Connective Tissue , ed 4. St Louis, CV Mosby Co, 1972;, pp 61-223.
Boucek RJ, Noble NL, Gunja-Smith Z, et al:  The Marfan syndrome: A deficiency in chemically stable collagen cross-links . N Engl J Med 1981;;305:988-991.
Link to Article
Pyeritz RE, Wappel MA:  Mitral valve dysfunction in Marfan syndrome . Am J Med 1983;;74:797-807.
Link to Article
Swartz MH, Teichholz LE, Donoso E:  Mitral valve prolapse: A review of associated arrhythmias . Am J Med 1977;;62:377-389.
Link to Article
Pickoff AS, Gelband H, Ferrar P, et al:  Premature ventricular contractions as the presenting feature of mitral valve prolapse in children . J Pediatr 1979;;94:615-617.
Link to Article
Kavey RW, Sondheimer HM, Blackman MS:  Detection of dysrhythmia in pediatric patients with mitral valve prolapse . Circulation 1980;;62: 582-587.
Link to Article
Moss AJ, Schwartz PJ:  Delayed repolarization (QT or QTU prolongation) and malignant ventricular arrhythmias . Mod Concepts Cardiovasc Dis 1982;;51:85-90.
Bekheit S, Ali A:  QT interval in idiopathic prolapsed mitral valve . Am J Cardiol 1978;;41: 374.
Link to Article
Puddu PE, Pasternac A, Tubau JF, et al:  QT interval prolongation and increased plasma catecholamine levels in patients with mitral valve prolapse . Am Heart J 1983;;105:422-428.
Link to Article
Soffer J, Dreifus LS, Michelson EL:  Polymorphous ventricular tachycardia associated with normal and long QT intervals . Am J Cardiol 1982;;49:2021-2029.
Link to Article
Wellens HJJ:  Value and limitations of programmed electrical stimulation of the heart in the study and treatment of tachycardias . Circulation 1978;;57:845-853.
Link to Article
Evans TR, Curry PVL, Fitchett DH, et al:  'Torsade de pointes' initiated by electrical ventricular stimulation . J Electrocardiol 1976;;9:255-258.
Link to Article
Horowitz LN, Greenspan AM, Spelman SR, et al:  Torsades de pointes: Electrophysiologic studies in patients without transient pharmacologic or metabolic abnormalities . Circulation 1981;;63:1120-1128.
Link to Article
Brugada P, Heddle B, Wellens HJJ:  Results of a ventricular stimulation protocol using a maximum of four premature stimuli in patients without documented or suspected ventricular arrhythmias . Circulation 1982;;66( (suppl 2) ):79.
Link to Article
El-Sherif N, Mehra R, Gough WB, et al:  Reentrant ventricular arrhythmias in late myocardial infarction period: II. Burst pacing versus multiple premature stimulation in the induction of reentry . J Am Coll Cardiol 1984;;4:295-304.
Link to Article
Akhtar M:  Clinical application of rapid ventricular burst pacing versus extra stimulation for induction of ventricular tachycardia . J Am Coll Cardiol 1984;;4:305-307.
Link to Article
James TN, Frame B, Schatz IJ:  Pathology of cardiac conduction system in Marfan syndrome . Arch Intern Med 1964;;114:339-343.
Link to Article

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