Clinical Challenges in Catecholaminergic Polymorphic Ventricular Tachycardia

Heart Lung Circ. 2016 Aug;25(8):777-83. doi: 10.1016/j.hlc.2016.01.012. Epub 2016 Feb 16.

Abstract

Catecholaminergic polymorphic ventricular tachycardia (CPVT) is an inheritable cardiac disorder associated with exercise- and stress-induced sudden death in young individuals. Although important steps forward have been made in the comprehension and treatment of this disease, several aspects remain unclear. Firstly, from an epidemiological standpoint the actual prevalence of CPVT is still unknown and possibly underestimated. In addition, the diagnostic process remains very challenging and can be supported by genetic analysis in only about half of the cases. Finally, up to one third of CPVT patients continue to present complex arrhythmias despite beta blocker treatment; the role of newer therapeutic options, such as flecainide and left cardiac sympathetic denervation, needs to be further elucidated. All these points constitute challenges for the cardiologist in the management of CPVT patients and fuel research into new diagnostic, prognostic and therapeutic approaches.

Keywords: Beta-blocker; Bidirectional ventricular tachycardia; CASQ2; Catecholaminergic polymorphic ventricular tachycardia; Exercise-induced cardiac arrest; Exercise-induced syncope; Flecainide; Implantable cardioverter defibrillator; RyR2; Sudden cardiac death.

Publication types

  • Review

MeSH terms

  • Female
  • Flecainide / therapeutic use
  • Humans
  • Male
  • Prevalence
  • Sympathectomy / methods
  • Tachycardia, Ventricular* / diagnosis
  • Tachycardia, Ventricular* / epidemiology
  • Tachycardia, Ventricular* / physiopathology
  • Tachycardia, Ventricular* / therapy

Substances

  • Flecainide

Supplementary concepts

  • Polymorphic catecholergic ventricular tachycardia