Catecholaminergic polymorphic ventricular tachycardia, an update

Ann Noninvasive Electrocardiol. 2018 Jul;23(4):e12512. doi: 10.1111/anec.12512. Epub 2017 Oct 19.

Abstract

Catecholaminergic polymorphic ventricular tachycardia is a rare devastating lethal inherited disorder or sporadic cardiac ion channelopathy characterized by unexplained syncopal episodes, and/or sudden cardiac death (SCD), aborted SCD (ASCD), or sudden cardiac arrest (SCA) observed in children, adolescents, and young adults without structural heart disease, consequence of adrenergically mediated arrhythmias: exercise-induced, by acute emotional stress, atrial pacing, or β-stimulant infusion, even when the electrocardiogram is normal. The entity is difficult to diagnose in the emergency department, given the range of presentations; thus, a familiarity with and high index of suspicion for this pathology are crucial. Furthermore, recognition of the characteristic findings and knowledge of the management of symptomatic patients are necessary, given the risk of arrhythmia recurrence and SCA. In this review, we will discuss the concept, epidemiology, genetic background, genetic subtypes, clinical presentation, electrocardiographic features, diagnosis criteria, differential diagnosis, and management.

Keywords: catecholaminergic polymorphic ventricular tachycardia; channelopathies; normal structural heart; sudden cardiac death/arrest.

Publication types

  • Review

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Electrocardiography / methods*
  • Heart Ventricles / diagnostic imaging
  • Heart Ventricles / physiopathology
  • Humans
  • Tachycardia, Ventricular / diagnosis*
  • Tachycardia, Ventricular / genetics
  • Tachycardia, Ventricular / physiopathology*
  • Young Adult

Supplementary concepts

  • Polymorphic catecholergic ventricular tachycardia