Catecholaminergic polymorphic ventricular tachycardia electrocardiogram
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mounika Reddy Vadiyala, M.B.B.S.[2]
Overview
Catecholaminergic polymorphic ventricular tachycardia patients usually have a normal resting ECG. However, in a subset of patients, sinus bradycardia, prominent U-waves, and supraventricular arrhythmias are seen.
Electrocardiogram
Resting ECG
- CPVT patients usually have a normal resting ECG, and the QT interval is usually not prolonged.[1][2][3]
- However, the following findings maybe seen in a subset of patients:
- Sinus bradycardia, in approximately 20% of patients, as another consequence of the diastolic calcium leakage facilitated by either RyR2 or CASQ2 mutations.[4][5]
- Prominent U-waves, which may also be related to altered intracellular calcium handling; its clinical significance is unknown.[6]
- Supraventricular arrhythmias, including isolated atrial ectopic beats, non-sustained supraventricular tachycardia and bursts of atrial fibrillation, are present in 16-26% of CPVT patients, maybe related to co-existing sinus node dysfunction.[1][7][8][9][10][11][12]
References
- ↑ 1.0 1.1 Leenhardt, Antoine; Lucet, Vincent; Denjoy, Isabelle; Grau, Francis; Ngoc, Dien Do; Coumel, Philippe (1995). “Catecholaminergic Polymorphic Ventricular Tachycardia in Children”. Circulation. 91 (5): 1512–1519. doi:10.1161/01.CIR.91.5.1512. ISSN 0009-7322.
- ↑ Hayashi, Meiso; Denjoy, Isabelle; Extramiana, Fabrice; Maltret, Alice; Buisson, Nathalie Roux; Lupoglazoff, Jean-Marc; Klug, Didier; Hayashi, Miyuki; Takatsuki, Seiji; Villain, Elisabeth; Kamblock, Joël; Messali, Anne; Guicheney, Pascale; Lunardi, Joël; Leenhardt, Antoine (2009). “Incidence and Risk Factors of Arrhythmic Events in Catecholaminergic Polymorphic Ventricular Tachycardia”. Circulation. 119 (18): 2426–2434. doi:10.1161/CIRCULATIONAHA.108.829267. ISSN 0009-7322.
- ↑ Sumitomo, N (2003). “Catecholaminergic polymorphic ventricular tachycardia: electrocardiographic characteristics and optimal therapeutic strategies to prevent sudden death”. Heart. 89 (1): 66–70. doi:10.1136/heart.89.1.66. ISSN 0007-0769.
- ↑ Postma, A V (2005). “Catecholaminergic polymorphic ventricular tachycardia: RYR2 mutations, bradycardia, and follow up of the patients”. Journal of Medical Genetics. 42 (11): 863–870. doi:10.1136/jmg.2004.028993. ISSN 1468-6244.
- ↑ Neco, Patricia; Torrente, Angelo G.; Mesirca, Pietro; Zorio, Esther; Liu, Nian; Priori, Silvia G.; Napolitano, Carlo; Richard, Sylvain; Benitah, Jean-Pierre; Mangoni, Matteo E.; Gómez, Ana María (2012). “Paradoxical Effect of Increased Diastolic Ca
2+
Release and Decreased Sinoatrial Node Activity in a Mouse Model of Catecholaminergic Polymorphic Ventricular Tachycardia”. Circulation. 126 (4): 392–401. doi:10.1161/CIRCULATIONAHA.111.075382. ISSN 0009-7322. line feed character in
|title=at position 45 (help) - ↑ Aizawa, Yoshiyasu; Komura, Satoru; Okada, Shinsuke; Chinushi, Masaomi; Aizawa, Yoshifusa; Morita, Hiroshi; Ohe, Tohru (2006). “Distinct U Wave Changes in Patients With Catecholaminergic Polymorphic Ventricular Tachycardia (CPVT)”. International Heart Journal. 47 (3): 381–389. doi:10.1536/ihj.47.381. ISSN 1349-2365.
- ↑ Sumitomo, Naokata; Sakurada, Harumizu; Taniguchi, Kazuo; Matsumura, Masaharu; Abe, Osamu; Miyashita, Michio; Kanamaru, Hiroshi; Karasawa, Kensuke; Ayusawa, Mamoru; Fukamizu, Seiji; Nagaoka, Iori; Horie, Minoru; Harada, Kensuke; Hiraoka, Masayasu (2007). “Association of Atrial Arrhythmia and Sinus Node Dysfunction in Patients With Catecholaminergic Polymorphic Ventricular Tachycardia”. Circulation Journal. 71 (10): 1606–1609. doi:10.1253/circj.71.1606. ISSN 1346-9843.
- ↑ Lawrenz, Wolfgang; Krogmann, Otto N.; Wieczorek, Marcus (2013). “Complex atrial arrhythmias as first manifestation of catecholaminergic polymorphic ventricular tachycardia: an unusual course in a patient with a new mutation in ryanodine receptor type 2 gene”. Cardiology in the Young. 24 (4): 741–744. doi:10.1017/S1047951113001091. ISSN 1047-9511.
- ↑ van der Werf, Christian; Nederend, Ineke; Hofman, Nynke; van Geloven, Nan; Ebink, Corné; Frohn-Mulder, Ingrid M.E.; Alings, A. Marco W.; Bosker, Hans A.; Bracke, Frank A.; van den Heuvel, Freek; Waalewijn, Reinier A.; Bikker, Hennie; van Tintelen, J. Peter; Bhuiyan, Zahurul A.; van den Berg, Maarten P.; Wilde, Arthur A.M. (2012). “Familial Evaluation in Catecholaminergic Polymorphic Ventricular Tachycardia”. Circulation: Arrhythmia and Electrophysiology. 5 (4): 748–756. doi:10.1161/CIRCEP.112.970517. ISSN 1941-3149.
- ↑ Sy, Raymond W.; Gollob, Michael H.; Klein, George J.; Yee, Raymond; Skanes, Allan C.; Gula, Lorne J.; Leong-Sit, Peter; Gow, Robert M.; Green, Martin S.; Birnie, David H.; Krahn, Andrew D. (2011). “Arrhythmia characterization and long-term outcomes in catecholaminergic polymorphic ventricular tachycardia”. Heart Rhythm. 8 (6): 864–871. doi:10.1016/j.hrthm.2011.01.048. ISSN 1547-5271.
- ↑ Sumitomo, Naokata; Nakamura, Takahiro; Fukuhara, Junji; Nakai, Toshiko; Watanabe, Ichiro; Mugishima, Hideo; Hiraoka, Masayasu (2010). “Clinical effectiveness of pulmonary vein isolation for arrhythmic events in a patient with catecholaminergic polymorphic ventricular tachycardia”. Heart and Vessels. 25 (5): 448–452. doi:10.1007/s00380-009-1214-6. ISSN 0910-8327.
- ↑ Faggioni, Michela; van der Werf, Christian; Knollmann, Bjorn C. (2014). “Sinus node dysfunction in catecholaminergic polymorphic ventricular tachycardia: Risk factor and potential therapeutic target?”. Trends in Cardiovascular Medicine. 24 (7): 273–278. doi:10.1016/j.tcm.2014.07.001. ISSN 1050-1738.
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