Catecholaminergic polymorphic ventricular tachycardia electrocardiogram: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Catecholaminergic polymorphic ventricular tachycardia}} | {{Catecholaminergic polymorphic ventricular tachycardia}} | ||
{{CMG}}; {{AE}} | {{CMG}}; {{AE}}{{MRV}} | ||
==Overview== | ==Overview== | ||
Catecholaminergic polymorphic ventricular tachycardia patients usually have a normal resting [[ECG]]. However, in a subset of patients, [[sinus bradycardia]], prominent [[U wave|U-waves]], and [[supraventricular arrhythmias]] are seen. | |||
==Electrocardiogram== | ==Electrocardiogram== | ||
===Resting ECG=== | |||
*[[CPVT]] patients usually have a normal resting [[ECG]], and the [[QT interval]] is usually not prolonged.<ref name="LeenhardtLucet1995">{{cite journal|last1=Leenhardt|first1=Antoine|last2=Lucet|first2=Vincent|last3=Denjoy|first3=Isabelle|last4=Grau|first4=Francis|last5=Ngoc|first5=Dien Do|last6=Coumel|first6=Philippe|title=Catecholaminergic Polymorphic Ventricular Tachycardia in Children|journal=Circulation|volume=91|issue=5|year=1995|pages=1512–1519|issn=0009-7322|doi=10.1161/01.CIR.91.5.1512}}</ref><ref name="HayashiDenjoy2009">{{cite journal|last1=Hayashi|first1=Meiso|last2=Denjoy|first2=Isabelle|last3=Extramiana|first3=Fabrice|last4=Maltret|first4=Alice|last5=Buisson|first5=Nathalie Roux|last6=Lupoglazoff|first6=Jean-Marc|last7=Klug|first7=Didier|last8=Hayashi|first8=Miyuki|last9=Takatsuki|first9=Seiji|last10=Villain|first10=Elisabeth|last11=Kamblock|first11=Joël|last12=Messali|first12=Anne|last13=Guicheney|first13=Pascale|last14=Lunardi|first14=Joël|last15=Leenhardt|first15=Antoine|title=Incidence and Risk Factors of Arrhythmic Events in Catecholaminergic Polymorphic Ventricular Tachycardia|journal=Circulation|volume=119|issue=18|year=2009|pages=2426–2434|issn=0009-7322|doi=10.1161/CIRCULATIONAHA.108.829267}}</ref><ref name="Sumitomo2003">{{cite journal|last1=Sumitomo|first1=N|title=Catecholaminergic polymorphic ventricular tachycardia: electrocardiographic characteristics and optimal therapeutic strategies to prevent sudden death|journal=Heart|volume=89|issue=1|year=2003|pages=66–70|issn=00070769|doi=10.1136/heart.89.1.66}}</ref> | |||
*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 [[Ryanodine receptor 2|RyR2]] or [[Calsequestrin|CASQ2]] [[mutations]].<ref name="Postma2005">{{cite journal|last1=Postma|first1=A V|title=Catecholaminergic polymorphic ventricular tachycardia: RYR2 mutations, bradycardia, and follow up of the patients|journal=Journal of Medical Genetics|volume=42|issue=11|year=2005|pages=863–870|issn=1468-6244|doi=10.1136/jmg.2004.028993}}</ref><ref name="NecoTorrente2012">{{cite journal|last1=Neco|first1=Patricia|last2=Torrente|first2=Angelo G.|last3=Mesirca|first3=Pietro|last4=Zorio|first4=Esther|last5=Liu|first5=Nian|last6=Priori|first6=Silvia G.|last7=Napolitano|first7=Carlo|last8=Richard|first8=Sylvain|last9=Benitah|first9=Jean-Pierre|last10=Mangoni|first10=Matteo E.|last11=Gómez|first11=Ana María|title= | |||
Paradoxical Effect of Increased Diastolic Ca | Paradoxical Effect of Increased Diastolic Ca | ||
2+ | 2+ | ||
Release and Decreased Sinoatrial Node Activity in a Mouse Model of Catecholaminergic Polymorphic Ventricular Tachycardia | Release and Decreased Sinoatrial Node Activity in a Mouse Model of Catecholaminergic Polymorphic Ventricular Tachycardia | ||
|journal=Circulation|volume=126|issue=4|year=2012|pages=392–401|issn=0009-7322|doi=10.1161/CIRCULATIONAHA.111.075382}}</ref> | |journal=Circulation|volume=126|issue=4|year=2012|pages=392–401|issn=0009-7322|doi=10.1161/CIRCULATIONAHA.111.075382}}</ref> | ||
* | *#Prominent [[U wave|U-waves]], which may also be related to altered [[intracellular]] [[calcium]] handling; its clinical significance is unknown.<ref name="AizawaKomura2006">{{cite journal|last1=Aizawa|first1=Yoshiyasu|last2=Komura|first2=Satoru|last3=Okada|first3=Shinsuke|last4=Chinushi|first4=Masaomi|last5=Aizawa|first5=Yoshifusa|last6=Morita|first6=Hiroshi|last7=Ohe|first7=Tohru|title=Distinct U Wave Changes in Patients With Catecholaminergic Polymorphic Ventricular Tachycardia (CPVT)|journal=International Heart Journal|volume=47|issue=3|year=2006|pages=381–389|issn=1349-2365|doi=10.1536/ihj.47.381}}</ref> | ||
* | *#[[Supraventricular arrhythmias]], including isolated [[ectopic atrial rhythm|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]].<ref name="LeenhardtLucet1995">{{cite journal|last1=Leenhardt|first1=Antoine|last2=Lucet|first2=Vincent|last3=Denjoy|first3=Isabelle|last4=Grau|first4=Francis|last5=Ngoc|first5=Dien Do|last6=Coumel|first6=Philippe|title=Catecholaminergic Polymorphic Ventricular Tachycardia in Children|journal=Circulation|volume=91|issue=5|year=1995|pages=1512–1519|issn=0009-7322|doi=10.1161/01.CIR.91.5.1512}}</ref><ref name="SumitomoSakurada2007">{{cite journal|last1=Sumitomo|first1=Naokata|last2=Sakurada|first2=Harumizu|last3=Taniguchi|first3=Kazuo|last4=Matsumura|first4=Masaharu|last5=Abe|first5=Osamu|last6=Miyashita|first6=Michio|last7=Kanamaru|first7=Hiroshi|last8=Karasawa|first8=Kensuke|last9=Ayusawa|first9=Mamoru|last10=Fukamizu|first10=Seiji|last11=Nagaoka|first11=Iori|last12=Horie|first12=Minoru|last13=Harada|first13=Kensuke|last14=Hiraoka|first14=Masayasu|title=Association of Atrial Arrhythmia and Sinus Node Dysfunction in Patients With Catecholaminergic Polymorphic Ventricular Tachycardia|journal=Circulation Journal|volume=71|issue=10|year=2007|pages=1606–1609|issn=1346-9843|doi=10.1253/circj.71.1606}}</ref><ref name="LawrenzKrogmann2013">{{cite journal|last1=Lawrenz|first1=Wolfgang|last2=Krogmann|first2=Otto N.|last3=Wieczorek|first3=Marcus|title=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|journal=Cardiology in the Young|volume=24|issue=4|year=2013|pages=741–744|issn=1047-9511|doi=10.1017/S1047951113001091}}</ref><ref name="van der WerfNederend2012">{{cite journal|last1=van der Werf|first1=Christian|last2=Nederend|first2=Ineke|last3=Hofman|first3=Nynke|last4=van Geloven|first4=Nan|last5=Ebink|first5=Corné|last6=Frohn-Mulder|first6=Ingrid M.E.|last7=Alings|first7=A. Marco W.|last8=Bosker|first8=Hans A.|last9=Bracke|first9=Frank A.|last10=van den Heuvel|first10=Freek|last11=Waalewijn|first11=Reinier A.|last12=Bikker|first12=Hennie|last13=van Tintelen|first13=J. Peter|last14=Bhuiyan|first14=Zahurul A.|last15=van den Berg|first15=Maarten P.|last16=Wilde|first16=Arthur A.M.|title=Familial Evaluation in Catecholaminergic Polymorphic Ventricular Tachycardia|journal=Circulation: Arrhythmia and Electrophysiology|volume=5|issue=4|year=2012|pages=748–756|issn=1941-3149|doi=10.1161/CIRCEP.112.970517}}</ref><ref name="SyGollob2011">{{cite journal|last1=Sy|first1=Raymond W.|last2=Gollob|first2=Michael H.|last3=Klein|first3=George J.|last4=Yee|first4=Raymond|last5=Skanes|first5=Allan C.|last6=Gula|first6=Lorne J.|last7=Leong-Sit|first7=Peter|last8=Gow|first8=Robert M.|last9=Green|first9=Martin S.|last10=Birnie|first10=David H.|last11=Krahn|first11=Andrew D.|title=Arrhythmia characterization and long-term outcomes in catecholaminergic polymorphic ventricular tachycardia|journal=Heart Rhythm|volume=8|issue=6|year=2011|pages=864–871|issn=15475271|doi=10.1016/j.hrthm.2011.01.048}}</ref><ref name="SumitomoNakamura2010">{{cite journal|last1=Sumitomo|first1=Naokata|last2=Nakamura|first2=Takahiro|last3=Fukuhara|first3=Junji|last4=Nakai|first4=Toshiko|last5=Watanabe|first5=Ichiro|last6=Mugishima|first6=Hideo|last7=Hiraoka|first7=Masayasu|title=Clinical effectiveness of pulmonary vein isolation for arrhythmic events in a patient with catecholaminergic polymorphic ventricular tachycardia|journal=Heart and Vessels|volume=25|issue=5|year=2010|pages=448–452|issn=0910-8327|doi=10.1007/s00380-009-1214-6}}</ref><ref name="Faggionivan der Werf2014">{{cite journal|last1=Faggioni|first1=Michela|last2=van der Werf|first2=Christian|last3=Knollmann|first3=Bjorn C.|title=Sinus node dysfunction in catecholaminergic polymorphic ventricular tachycardia: Risk factor and potential therapeutic target?|journal=Trends in Cardiovascular Medicine|volume=24|issue=7|year=2014|pages=273–278|issn=10501738|doi=10.1016/j.tcm.2014.07.001}}</ref> | ||
==References== | ==References== | ||
Latest revision as of 15:34, 23 July 2020
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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.