The Evaluation of the Onset and Follow Up of Electrocardiograms and Arrhythmias in Children with Fulminant Myocarditis

Background: Fulminant myocarditis has various serious arrhythmias. We investigated the electrocardiogram findings, arrhythmogenicity and abnormalities of the cardiac conduction system in children with fulminant myocarditis (FM). Methods and Results: Between 1999 and 2008, 7 consecutive patients (mean age 7 years) who suffered from FM were included in this study. A 12-lead electrocardiogram, Holter monitoring and signal averaged electrocardiograms were performed and compared between the acute, convalescent, and remote phases in the 4 surviving patients. Also, an electrophysiologic study was performed during the convalescent phase. A myocardial scintigraphy was performed during the convalescent and remote phases. Five out of 7 developed CAVB, 3 VT, 2 cardiac arrest, 2 sinus tachycardia, 1 VF, 1 advanced AVB, and 1 SSS. Among the surviving patients, all these arrhythmia were resolved during the convalescent phase. No arrhythmias were induced in any patients during the programmed stimulation study. The results of the myocardial scintigraphy of these patients in the remote phase revealed normal LV function. Conclusion: Various arrhythmias that developed during the acute phase resolved during the convalescent and in children with FM. During the electrophysiological study in the convalescent phase, no arrhythmias could be induced and there were no signs of any conduction abnormalities.