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:
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.