Catecholaminergic Polymorphic Ventricular Tachycardia

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Author(s) P.G. Postema, MD
Moderator P.G. Postema, MD
Supervisor
some notes about authorship

Catecholaminergic Polymorphic Ventricular Tachycardia is a congenital disease that leads to exercise induced ventricular arrhythmias and / or syncope and carries an increased risk of sudden death.

Characteristics of CPVT:

  • Arrhythmias can start at young age, but sometimes do not occur before adulthood.

Diagnosis

  • The diagnosis is based on reproducible ventricular arrhythmias during exercise testing. Typically the onset of ventricular arrhythmias is at around 100-120 bpm. The complexity of these arrhythmias often increases with increasing work load, starting with Ventricular Premature Beats, bidirectional ventricular tachycardia to polymorphic ventricular tachycardia.
  • Two genes have been linked to CPVT. Both lead to a defect in intracellular calcium metabolism:
    • the hRyR2 gene, coding for the cardiac ryanodine receptor: (OMIM™ link 180902) (50-55 % of patients)
    • the CASQ2 gene, coding for the calsequestrine protein: (OMIM™ link 114251) (1-2 % of patients)

Treatment Treatment consist of:ACC2006

  • Beta-blockers
  • ICD implantation combined with beta-blockers in CPVT patients who survived a cardiac arrest.
  • Avoid competitive and other strenuous exercise

External Links

References

<biblio>

  1. ACC2006 pmid=16935995

</biblio>