The Short-term Follow-up Of The Frequent Atrial Premature Contraction In Suspected Viral Myocarditis Children

ObjectiveViral myocarditis is a common cardiovascular disease in children, but typical viral myocarditis or severe myocarditis is infrequent. For most children who have frequent premature contraction, the myocardial enzymes are nomal or elevated slightly. In such cases, the viral myocarditis couldn’t be conformed nor excluded, and the decision about further treatment is difficult. According to our experience in the treatment of such cases during the past ten years, we consider some of these patients suffer from mild myocarditis, and the myocardial nutrition therapy is essential. So we collected the frequent premature atrial contraction patients of such kind admitted by the pediatric department of our hospital during the past ten years, analysed their prognosis, Holter features, and the relationship between the two. The objective is to provide more evidence for the diagnosis and treatment.MethodsWe collected41suspected viral myocarditis patients admitted by the pediatric department of our hospital from2002year to2012year whose main manifestations were frequent atrial premature contraction, and then analysed their auxiliary examination results, such as myocardial enzymes, ultrasound testing, X ray photography and emission computed tomography, also analysed the features of Holter, including coupling interval, the shape and origination of the atrial ectopic contraction. We also wanted to know whether the atrial tachycardia and the pararrythmia occurred, and whether these testing results could support the diagonis of viral myocardits when connected with the prognosis of these patients.Results130cases (73%) whose total atrial premature contractions in the Holter were below20000,4cases (10%) were atrial pararrhythmia,35cases (85%) with the atrial ectopic P’wave merged into T wave,14cases (32%) coexisted with atrial tachycardia, most premature contractions were monophyletic and originated from the lower part of the atrium.2After2weeks of antivirus, myocardial nutrition, antioxidant treatment and traditional Chinese medicine therapy, the premature contraction decreased more than30%in half of the patients.3The premature contraction decreased more remarkably in patients with atrial tachycardia than those with pure atrial premature contraction.ConclusionFor the frequent atrial premature contraction in suspected viral myocarditis children, especially for those coexisted with atrial tachycardia, the most commen reason is viral myocarditis, and the atrial premature contranction could decrease or disappear after treatment based on this diagnosis.