Predicting factors for unresolved premature ventricular complexes in healthy children.

Background: Premature ventricular complexes (PVCs) are generally benign in healthy children, but in some cases, a persistent high PVC burden may be observed, potentially related to ventricular tachycardia or left ventricular dysfunction. This study explores the natural history of PVCs in children with structurally normal hearts and identifies factors associated with unresolved PVCs.

Methods: We retrospectively analyzed demographic and clinical data from children < 18 years of age with confirmed PVCs, including 12-lead electrocardiogram (ECG) and 24-h Holter monitoring data.

Results: A total of 113 children (mean age 8.35 ± 5.28 years, 71 males [62.8%]) were included. The mean follow-up duration was 44.9 ± 44.8 months. PVC burden at initial diagnosis was 13.54 ± 12.53%. During follow-up, 44.2% of patients showed complete PVC improvement, 13.3% partial improvement, and 42.5% persistent. Older age at the initial onset and female sex were associated with unresolved PVCs (per 1-year increase: OR 1.09, 95% CI: 1.01-1.18, P = 0.027; females: OR 2.25, 95% CI: 1.00-5.06, P = 0.050).

Conclusion: Older age at onset and female sex were predictors of unresolved PVCs in healthy children, highlighting the need for tailored monitoring for these subgroups, despite the generally favorable prognosis of PVCs.