Catecholaminergic polymorphic ventricular tachycardia other diagnostic studies: Difference between revisions
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==Other Diagnostic Studies== | ==Other Diagnostic Studies== | ||
Other diagnostic studies for catecholaminergic polymorphic ventricular tachycardia include: | |||
*[[Epinephrine]] Infusion | |||
**[[Epinephrine]] infusion is an alternative to establish the diagnosis [[CPVT]] in patients who cannot perform an [[Exercise stress testing|exercise stress test]].<ref name="PrioriWilde2013">{{cite journal|last1=Priori|first1=Silvia G.|last2=Wilde|first2=Arthur A.|last3=Horie|first3=Minoru|last4=Cho|first4=Yongkeun|last5=Behr|first5=Elijah R.|last6=Berul|first6=Charles|last7=Blom|first7=Nico|last8=Brugada|first8=Josep|last9=Chiang|first9=Chern-En|last10=Huikuri|first10=Heikki|last11=Kannankeril|first11=Prince|last12=Krahn|first12=Andrew|last13=Leenhardt|first13=Antoine|last14=Moss|first14=Arthur|last15=Schwartz|first15=Peter J.|last16=Shimizu|first16=Wataru|last17=Tomaselli|first17=Gordon|last18=Tracy|first18=Cynthia|last19=Ackerman|first19=Michael|last20=Belhassen|first20=Bernard|last21=Estes|first21=N. A. Mark|last22=Fatkin|first22=Diane|last23=Kalman|first23=Jonathan|last24=Kaufman|first24=Elizabeth|last25=Kirchhof|first25=Paulus|last26=Schulze-Bahr|first26=Eric|last27=Wolpert|first27=Christian|last28=Vohra|first28=Jitendra|last29=Refaat|first29=Marwan|last30=Etheridge|first30=Susan P.|last31=Campbell|first31=Robert M.|last32=Martin|first32=Edward T.|last33=Quek|first33=Swee Chye|title=Executive summary: HRS/EHRA/APHRS expert consensus statement on the diagnosis and management of patients with inherited primary arrhythmia syndromes|journal=EP Europace|volume=15|issue=10|year=2013|pages=1389–1406|issn=1532-2092|doi=10.1093/europace/eut272}}</ref> | |||
**In a study of 36 [[CPVT]] patients and 45 unaffected relatives, reported doses of [[epinephrine]] escalated from 0.05 mcg/kg/min to 0.1 mcg/kg/min to a maximum of 0.20 mcg/kg/min; and the mean maximum [[heart rate]] was significantly lower than the maximum heart rate achieved during [[Exercise stress testing|exercise testing]].<ref name="MarjamaaHiippala2012">{{cite journal|last1=Marjamaa|first1=Annukka|last2=Hiippala|first2=Anita|last3=Arrhenius|first3=Bianca|last4=Lahtinen|first4=Annukka M.|last5=Kontula|first5=Kimmo|last6=Toivonen|first6=Lauri|last7=Happonen|first7=Juha-Matti|last8=Swan|first8=Heikki|title=Intravenous Epinephrine Infusion Test in Diagnosis of Catecholaminergic Polymorphic Ventricular Tachycardia|journal=Journal of Cardiovascular Electrophysiology|volume=23|issue=2|year=2012|pages=194–199|issn=10453873|doi=10.1111/j.1540-8167.2011.02188.x}}</ref> | |||
**[[Epinephrine]] test appears to be highly [[specificity|specific]] (98%), but not as [[sensitivity|sensitive]] as the [[Exercise stress testing|exercise test]] for provoking [[arrhythmia]] in [[CPVT]] patients.<ref name="MarjamaaHiippala2012">{{cite journal|last1=Marjamaa|first1=Annukka|last2=Hiippala|first2=Anita|last3=Arrhenius|first3=Bianca|last4=Lahtinen|first4=Annukka M.|last5=Kontula|first5=Kimmo|last6=Toivonen|first6=Lauri|last7=Happonen|first7=Juha-Matti|last8=Swan|first8=Heikki|title=Intravenous Epinephrine Infusion Test in Diagnosis of Catecholaminergic Polymorphic Ventricular Tachycardia|journal=Journal of Cardiovascular Electrophysiology|volume=23|issue=2|year=2012|pages=194–199|issn=10453873|doi=10.1111/j.1540-8167.2011.02188.x}}</ref> | |||
**Patients undergoing an [[epinephrine]] infusion should have continuous [[ECG]] monitoring. | |||
*[[Holter monitor|Holter monitoring]] | |||
**[[Exercise stress testing]] and [[epinephrine]] infusion should be complemented by 24-hours [[Holter monitor|Holter]] recordings. | |||
[ | **In individuals unable to perform an [[Exercise stress testing|exercise test]], especially infants and children or patients whose symptoms are more emotion-related rather than exercise-related, [[Holter monitor|Holter monitoring]] can be performed. | ||
*[ | **[[Holter monitor|Holter monitoring]] is also useful to detect the presence of [[supraventricular arrhythmias]]. | ||
**[[Holter monitor|Holter monitoring]] is less [[sensitivity|sensitive]] than [[Exercise stress testing|exercise testing]].<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> | |||
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==References== | ==References== | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Overview
Other diagnostic studies for catecholaminergic polymorphic ventricular tachycardia include epinephrine infusion and holter monitoring.
Other Diagnostic Studies
Other diagnostic studies for catecholaminergic polymorphic ventricular tachycardia include:
- Epinephrine Infusion
- Epinephrine infusion is an alternative to establish the diagnosis CPVT in patients who cannot perform an exercise stress test.[1]
- In a study of 36 CPVT patients and 45 unaffected relatives, reported doses of epinephrine escalated from 0.05 mcg/kg/min to 0.1 mcg/kg/min to a maximum of 0.20 mcg/kg/min; and the mean maximum heart rate was significantly lower than the maximum heart rate achieved during exercise testing.[2]
- Epinephrine test appears to be highly specific (98%), but not as sensitive as the exercise test for provoking arrhythmia in CPVT patients.[2]
- Patients undergoing an epinephrine infusion should have continuous ECG monitoring.
- Holter monitoring
- Exercise stress testing and epinephrine infusion should be complemented by 24-hours Holter recordings.
- In individuals unable to perform an exercise test, especially infants and children or patients whose symptoms are more emotion-related rather than exercise-related, Holter monitoring can be performed.
- Holter monitoring is also useful to detect the presence of supraventricular arrhythmias.
- Holter monitoring is less sensitive than exercise testing.[3]
References
- ↑ Priori, Silvia G.; Wilde, Arthur A.; Horie, Minoru; Cho, Yongkeun; Behr, Elijah R.; Berul, Charles; Blom, Nico; Brugada, Josep; Chiang, Chern-En; Huikuri, Heikki; Kannankeril, Prince; Krahn, Andrew; Leenhardt, Antoine; Moss, Arthur; Schwartz, Peter J.; Shimizu, Wataru; Tomaselli, Gordon; Tracy, Cynthia; Ackerman, Michael; Belhassen, Bernard; Estes, N. A. Mark; Fatkin, Diane; Kalman, Jonathan; Kaufman, Elizabeth; Kirchhof, Paulus; Schulze-Bahr, Eric; Wolpert, Christian; Vohra, Jitendra; Refaat, Marwan; Etheridge, Susan P.; Campbell, Robert M.; Martin, Edward T.; Quek, Swee Chye (2013). "Executive summary: HRS/EHRA/APHRS expert consensus statement on the diagnosis and management of patients with inherited primary arrhythmia syndromes". EP Europace. 15 (10): 1389–1406. doi:10.1093/europace/eut272. ISSN 1532-2092.
- ↑ 2.0 2.1 Marjamaa, Annukka; Hiippala, Anita; Arrhenius, Bianca; Lahtinen, Annukka M.; Kontula, Kimmo; Toivonen, Lauri; Happonen, Juha-Matti; Swan, Heikki (2012). "Intravenous Epinephrine Infusion Test in Diagnosis of Catecholaminergic Polymorphic Ventricular Tachycardia". Journal of Cardiovascular Electrophysiology. 23 (2): 194–199. doi:10.1111/j.1540-8167.2011.02188.x. ISSN 1045-3873.
- ↑ 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.