Catecholaminergic polymorphic ventricular tachycardia other diagnostic studies
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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
Other diagnostic studies for catecholaminergic polymorphic ventricular tachycardia include epinephrine infusion and holter monitoring. In patients who cannot perform an exercise stress test, epinephrine infusion and Holter monitoring help to establish the diagnosis of CPVT.
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.