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Rev. invest. clín ; 71(4): 226-236, Jul.-Aug. 2019. tab, graf
Article in English | LILACS | ID: biblio-1289691

ABSTRACT

Abstract Catecholaminergic polymorphic ventricular tachycardia (CPVT) is a potentially lethal disease, whose characteristic ventricular tachycardias are adrenergic-dependent. Although rare, CPVT should be considered in the differential diagnosis of young individuals with exercise-induced syncope. Mutations in five different genes (RYR2, CASQ2, CALM1, TRDN, and TECRL) are associated with the CPVT phenotype, although RYR2 missense mutations are implicated in up to 60 % of all CPVT cases. Genetic testing has an essential role in the diagnosis, management, pre-symptomatic diagnosis, counseling, and treatment of the proband; furthermore, genetic information can be useful for offspring and relatives. By expert consensus, CPVT gene testing is a Class I recommendation for patients with suspected CPVT. Beta-adrenergic and calcium-channel blockers are the cornerstones of treatment due to the catecholaminergic dependence of the arrhythmias. Unresponsive patients are treated with an implantable cardioverter-defibrillator to reduce the risk of sudden cardiac death. In the present article, a brief review of the genetic and molecular mechanisms of this intriguing disease is provided.


Subject(s)
Humans , Death, Sudden, Cardiac/prevention & control , Tachycardia, Ventricular/diagnosis , Defibrillators, Implantable , Syncope/diagnosis , Genetic Testing , Tachycardia, Ventricular/genetics , Tachycardia, Ventricular/therapy , Diagnosis, Differential , Mutation
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