scholarly journals Vitamin D as a Substitute of Catheter Ablation in a Paediatric Patient with High Burden Premature Ventricular Contractions: A Case Report

Author(s):  
Gabriel Cismaru ◽  
Cecilia Lazea ◽  
Simona Cainap ◽  
Daniela Iacob

Catheter ablation is established as a treatment option for patients with high number Premature Ventricular Contractions (PVCs). However, complications can occur: cardiac tamponade, coronary artery injury or infectious endocarditis. Reversible causes such as hypocalcaemia, hypomagnesaemia and hypokalemia can be responsible for PVCs. Here, a case of nine years old boy, with vitamin D deficiency that presented high number PVCs which corrected using vitamin D dietary supplementation was described. A nine-year-old boy was hospitalised in the Cardiology Department for catheter ablation of PVCs. He presented short of breath during football matches and asthenia. Electrocardiography(ECG) and Holter ECG demonstrated high number PVCs with a morphology consistent of Right Ventricular Outflow Tract (RVOT) origin. Catheter ablation was postponed until Vitamin D came to normal values. Dietary supplementation was performed, together with Holter ECG monitoring. After vitamin D normalisation, PVC burden reduced significantly without the need of catheter ablation or anti-arrhythmic drugs. Catheter ablation and anti-arrhythmic drugs can be avoided in patients with frequent PVCs and vitamin D deficiency.

2020 ◽  
Vol 13 (5) ◽  
pp. e233411
Author(s):  
John Daveney ◽  
Thomas Nguyen ◽  
Matt Wright

The case concerns a difficult but successful right ventricular outflow tract ectopy catheter ablation in a fit and well 33-year-old man with a 16-year history of symptomatic premature ventricular contractions (PVCs). Beta blockade medication had become ineffective in suppressing the PVCs, and a 24-hour Holter monitor revealed a high burden of ectopy (10%). An echocardiogram and cardiac MRI showed a structurally normal heart. During the procedure, it became impossible to uncurve the catheter, and it lodged in the patient’s right femoral artery. Immediate collaboration with interventional cardiology and interventional radiology was required to resolve the issue. The case demonstrates that excellent teamwork and calling rapidly on input from subspecialties are integral to overcoming unexpected events and to achieve a safe and successful outcome. The patient involved was a medical student at the time and as one of the coauthors offers a unique insight.


2021 ◽  
Vol 11 (2) ◽  
pp. 220-223
Author(s):  
Gabriel Cismaru ◽  
Cecilia Lazea ◽  
Daniela Iacob ◽  
Simona Cainap

Vitamin D receptor is present in almost every cell of the body. Although some studies have suggested that values >30ng/ml would be sufficient, there is no consensus on the optimal values of serum vitamin D. Vitamin D deficiency can lead to “benign” manifestations, such as back pain, joint pain, fatigue, and heavy sweating. Premature ventricular contractions (PVCs) originating from the right ventricular outflow tract (RVOT) are considered “benign,” as they occur in patients without structural heart disease and their exact cause remains unknown. We describe the case of a 10-year-old boy with frequent PVCs and vitamin D deficiency that was corrected after vitamin D supplementation. On the contrary, his twin brother had normal serum vitamin D and no PVCs. The disappearance of PVCs occurred after treatment with vitamin D 2000 IU/day.


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