Electrocardiographic Comparison of Ventricular Premature Complexes during Exercise Test in Patients with CPVT and Healthy Subjects.
Background Catecholaminergic polymorphic ventricular tachycardia (CPVT) is a rare but highly malignant inherited arrhythmic disorder. Although a standardized exercise stress test (ST) is the most reliable way to diagnose CPVT, in 30% only single ventricular premature beats (VPCs) were recorded. Obje...
| Publicado en: | Pacing & Clinical Electrophysiology Vol. 38; no. 3; pp. 398 - 403 |
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| Autores principales: | , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Wiley-Blackwell
Mar2015
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=103766935&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 103766935 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 01478389 4F8 jtl: Pacing & Clinical Electrophysiology issn: 01478389 maglogo: Y pubinfo: dt: Mar2015 vid: 38 iid: 3 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 103766935 101314526 10.1111/pace.12574 103766935 ppf: 398 ppct: 5 formats: fmt: @attributes: type: P tig: atl: Electrocardiographic Comparison of Ventricular Premature Complexes during Exercise Test in Patients with CPVT and Healthy Subjects. aug: au: Blich, Miry Marai, Ibrahim Suleiman, Mahmoud Lorber, Avraham Gepstein, Lior Boulous, Monther Khoury, Asaad affil: Division of Pacing and Electrophysiology, Rambam Health Care Campus and Bruce Rappaport Faculty of Medicine sug: subj: Tachycardia, Ventricular Diagnosis Mutation Premature Ventricular Contractions Exercise Test, Cardiopulmonary Methods Electrocardiography Utilization Human Descriptive Statistics Odds Ratio Confidence Intervals Prospective Studies Mann-Whitney U Test T-Tests Chi Square Test Fisher's Exact Test ROC Curve Logistic Regression Data Analysis Software Child Adolescence Young Adult Adult Middle Age Female Male Child: 6-12 years Adolescent: 13-18 years Adult: 19-44 years Middle Aged: 45-64 years Female Male ab: Background Catecholaminergic polymorphic ventricular tachycardia (CPVT) is a rare but highly malignant inherited arrhythmic disorder. Although a standardized exercise stress test (ST) is the most reliable way to diagnose CPVT, in 30% only single ventricular premature beats (VPCs) were recorded. Objective To evaluate whether electrocardiographic characteristics of VPCs during ST distinguish patients with CPVT from healthy subjects. Methods Electrocardiographic characteristics of VPCs during ST in 16 calsequestrin-2 (CASQ2) mutation carriers CPVT patients were compared with that in 36 healthy subjects. Results CPVT patients had more VPCs (31 ± 14 vs 3 ± 4, P < 0.0001), longer QRS duration (139 ± 18 ms vs 121 ± 21, P = 0.004), and coupling interval (CI; 476 ± 58 ms vs 355 ± 61 ms, P < 0.0001). The most sensitive characteristics for CPVT were >10 VPCs/test (100% sensitivity, 100% negative predictive value [NPV]), left bundle branch block (LBBB) pattern with inferior axis (88% sensitivity, 94% NPV), and CI longer than 400 ms (88% sensitivity, 94% NPV). Bigeminy or trigeminy or LBBB pattern with inferior axis was most specific for CPVT at 100% (100% positive predictive value PPV, 92% NPV). First VPC during the recovery period and VPC recording more than 1 minute during the recovery period were most specific for healthy subjects (100% specificity, 100% PPV). In multivariate analysis, QRS duration >120 ms (odds ratio 4.2, 95% confidence interval 1-17.6, P = 0.04) and first VPC at ≥10 mets (odds ratio 9.1, 95% confidence interval 2.01-41.1, P = 0.004) each predicted the presence of CPVT. Conclusions Several electrocardiographic criteria can help distinguish VPCs originating from CPVT compared with healthy subjects. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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