Heart Rate Recovery After Exercise Is Associated With Arrhythmic Events in Patients With Catecholaminergic Polymorphic Ventricular Tachycardia.

Adult Electrocardiography Exercise / physiology Exercise Test Female Follow-Up Studies Heart Rate / physiology Humans Male Middle Aged Recovery of Function / physiology Retrospective Studies Tachycardia, Ventricular / diagnosis Vagus Nerve / physiopathology Young Adult
autonomic nervous system death, sudden exercise test heart rate humans

Journal

Circulation. Arrhythmia and electrophysiology
ISSN: 1941-3084
Titre abrégé: Circ Arrhythm Electrophysiol
Pays: United States
ID NLM: 101474365

Informations de publication

Date de publication:
03 2020
Historique:
pubmed: 18 2 2020
medline: 20 8 2020
entrez: 18 2 2020
Statut: ppublish

Résumé

Risk stratification in catecholaminergic polymorphic ventricular tachycardia remains ill defined. Heart rate recovery (HRR) immediately after exercise is regulated by autonomic reflexes, particularly vagal tone, and may be associated with symptoms and ventricular arrhythmias in patients with catecholaminergic polymorphic ventricular tachycardia. Our objective was to evaluate whether HRR after maximal exercise on the exercise stress test (EST) is associated with symptoms and ventricular arrhythmias. In this retrospective observational study, we included patients ≤65 years of age with an EST without antiarrhythmic drugs who attained at least 80% of their age- and sex-predicted maximal HR. HRR in the recovery phase was calculated as the difference in heart rate (HR) at maximal exercise and at 1 minute in the recovery phase (ΔHRR1'). We included 187 patients (median age, 36 years; 68 [36%] symptomatic before diagnosis). Pre-EST HR and maximal HR were equal among symptomatic and asymptomatic patients. Patients who were symptomatic before diagnosis had a greater ΔHRR1' after maximal exercise (43 [interquartile range, 25-58] versus 25 [interquartile range, 19-34] beats/min; Catecholaminergic polymorphic ventricular tachycardia patients with a larger HRR following exercise are more likely to be symptomatic and have complex ventricular arrhythmias during the first EST off antiarrhythmic drug.

Sections du résumé

BACKGROUND
Risk stratification in catecholaminergic polymorphic ventricular tachycardia remains ill defined. Heart rate recovery (HRR) immediately after exercise is regulated by autonomic reflexes, particularly vagal tone, and may be associated with symptoms and ventricular arrhythmias in patients with catecholaminergic polymorphic ventricular tachycardia. Our objective was to evaluate whether HRR after maximal exercise on the exercise stress test (EST) is associated with symptoms and ventricular arrhythmias.
METHODS
In this retrospective observational study, we included patients ≤65 years of age with an EST without antiarrhythmic drugs who attained at least 80% of their age- and sex-predicted maximal HR. HRR in the recovery phase was calculated as the difference in heart rate (HR) at maximal exercise and at 1 minute in the recovery phase (ΔHRR1').
RESULTS
We included 187 patients (median age, 36 years; 68 [36%] symptomatic before diagnosis). Pre-EST HR and maximal HR were equal among symptomatic and asymptomatic patients. Patients who were symptomatic before diagnosis had a greater ΔHRR1' after maximal exercise (43 [interquartile range, 25-58] versus 25 [interquartile range, 19-34] beats/min;
CONCLUSIONS
Catecholaminergic polymorphic ventricular tachycardia patients with a larger HRR following exercise are more likely to be symptomatic and have complex ventricular arrhythmias during the first EST off antiarrhythmic drug.

Identifiants

DOI: 10.1161/CIRCEP.119.007471 PMID: 32063070
pubmed: 32063070
doi: 10.1161/CIRCEP.119.007471
doi:

Types de publication

Journal Article Multicenter Study Observational Study Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

e007471

Auteurs

Krystien V V Lieve (KVV)

Department of Clinical and Experimental Cardiology, Heart Center (K.V.V.L., C.v.d.W., N.H., S.-A.B.C., A.A.M.W.), the Netherlands.
European Reference Network 'ERN GUARD-Heart' (K.V.V.L., V.D., C.v.d.W., A.D., I.D., H.B., F.R.I.N., T.R., N.H., J.T., J.T.-H., V.P., A.L., H.S., P.J.S., A.A.M.W.).

Veronica Dusi (V)

European Reference Network 'ERN GUARD-Heart' (K.V.V.L., V.D., C.v.d.W., A.D., I.D., H.B., F.R.I.N., T.R., N.H., J.T., J.T.-H., V.P., A.L., H.S., P.J.S., A.A.M.W.).
Department of Molecular Medicine, Section of Cardiology, University of Pavia, Italy (V.D.).
Cardiac Intensive Care Unit, Arrhythmia and Electrophysiology and Experimental Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy (V.D.).

Christian van der Werf (C)

Department of Clinical and Experimental Cardiology, Heart Center (K.V.V.L., C.v.d.W., N.H., S.-A.B.C., A.A.M.W.), the Netherlands.
European Reference Network 'ERN GUARD-Heart' (K.V.V.L., V.D., C.v.d.W., A.D., I.D., H.B., F.R.I.N., T.R., N.H., J.T., J.T.-H., V.P., A.L., H.S., P.J.S., A.A.M.W.).

J Martijn Bos (JM)

Department of Cardiovascular Medicine, Division of Heart Rhythm Services (J.M.B., C.M.L., M.J.A.), Mayo Clinic, Rochester, MN.
Department of Pediatric and Adolescent Medicine, Division of Pediatric Cardiology (J.M.B., C.M.L., M.J.A.), Mayo Clinic, Rochester, MN.
Department of Molecular Pharmacology and Experimental Therapeutics, Windland Smith Rice Sudden Death Genomics Laboratory (J.M.B., C.M.L., M.J.A.), Mayo Clinic, Rochester, MN.

Conor M Lane (CM)

Department of Cardiovascular Medicine, Division of Heart Rhythm Services (J.M.B., C.M.L., M.J.A.), Mayo Clinic, Rochester, MN.
Department of Pediatric and Adolescent Medicine, Division of Pediatric Cardiology (J.M.B., C.M.L., M.J.A.), Mayo Clinic, Rochester, MN.
Department of Molecular Pharmacology and Experimental Therapeutics, Windland Smith Rice Sudden Death Genomics Laboratory (J.M.B., C.M.L., M.J.A.), Mayo Clinic, Rochester, MN.

Mathis Korseberg Stokke (MK)

Department of Cardiology, Center for Cardiological Innovation, Oslo University Hospital, Rikshospitalet, University of Oslo, Norway (M.K.S., K.H.H.).

Thomas M Roston (TM)

Department of Pediatrics, Children's Heart Centre, Division of Cardiology, British Columbia Children's Hospital, Vancouver, BC, Canada (T.M.R., S.S.).

Aurora Djupsjöbacka (A)

European Reference Network 'ERN GUARD-Heart' (K.V.V.L., V.D., C.v.d.W., A.D., I.D., H.B., F.R.I.N., T.R., N.H., J.T., J.T.-H., V.P., A.L., H.S., P.J.S., A.A.M.W.).
Heart and Lung Center, Helsinki University Hospital, Helsinki University, Finland (A.D., H.S.).

Yuko Wada (Y)

Department of Cardiovascular Medicine, Shiga University of Medical Science, Otsu, Japan (Y.W., M.H.).

Isabelle Denjoy (I)

European Reference Network 'ERN GUARD-Heart' (K.V.V.L., V.D., C.v.d.W., A.D., I.D., H.B., F.R.I.N., T.R., N.H., J.T., J.T.-H., V.P., A.L., H.S., P.J.S., A.A.M.W.).
CNMR Maladies Cardiaques Héréditaires Rares, Hôpital Bichat, Paris, France (I.D., A.L.).
Université Paris Diderot, Sorbonne Paris Cité, France (I.D., A.L.).
AP-HP, Service de Cardiologie, Hôpital Bichat, Paris, France (I.D., A.L.).

Henning Bundgaard (H)

European Reference Network 'ERN GUARD-Heart' (K.V.V.L., V.D., C.v.d.W., A.D., I.D., H.B., F.R.I.N., T.R., N.H., J.T., J.T.-H., V.P., A.L., H.S., P.J.S., A.A.M.W.).
Capital Regions Unit for Inherited Cardiac Diseases, Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Denmark (H.B.).

Ferran Roses I Noguer (FRI)

European Reference Network 'ERN GUARD-Heart' (K.V.V.L., V.D., C.v.d.W., A.D., I.D., H.B., F.R.I.N., T.R., N.H., J.T., J.T.-H., V.P., A.L., H.S., P.J.S., A.A.M.W.).
Department of Cardiology, Royal Brompton Hospital, London, United Kingdom (F.R.I.N., J.T.).

Christopher Semsarian (C)

Agnes Ginges Center for Molecular Cardiology, Centenary Institute, University of Sydney, Australia (C.S.).
Department of Cardiology, Royal Prince Alfred Hospital, Camperdown, NSW, Australia (C.S.).

Tomas Robyns (T)

European Reference Network 'ERN GUARD-Heart' (K.V.V.L., V.D., C.v.d.W., A.D., I.D., H.B., F.R.I.N., T.R., N.H., J.T., J.T.-H., V.P., A.L., H.S., P.J.S., A.A.M.W.).
Department of Cardiovascular Diseases, University Hospitals Leuven, Belgium (T.R.).

Nynke Hofman (N)

Department of Clinical and Experimental Cardiology, Heart Center (K.V.V.L., C.v.d.W., N.H., S.-A.B.C., A.A.M.W.), the Netherlands.
European Reference Network 'ERN GUARD-Heart' (K.V.V.L., V.D., C.v.d.W., A.D., I.D., H.B., F.R.I.N., T.R., N.H., J.T., J.T.-H., V.P., A.L., H.S., P.J.S., A.A.M.W.).

Michael W Tanck (MW)

Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam UMC (M.W.T.), the Netherlands.

Maarten P van den Berg (MP)

Department of Cardiology, University of Groningen, University Medical Center Groningen, the Netherlands (M.P.v.d.B.).

Janneke A E Kammeraad (JAE)

Department of Pediatric Cardiology, Sophia Children's Hospital, Erasmus Medical Center, Rotterdam, the Netherlands (J.A.E.K.).

Andrew D Krahn (AD)

Heart Rhythm Research, Division of Cardiology, University of British Columbia, Vancouver, Canada (A.D.K.).

Sally-Ann B Clur (SB)

Department of Clinical and Experimental Cardiology, Heart Center (K.V.V.L., C.v.d.W., N.H., S.-A.B.C., A.A.M.W.), the Netherlands.

Frederic Sacher (F)

Bordeaux University Hospital, LIRYC Institute, Pessac, France (F.S.).

Jan Till (J)

European Reference Network 'ERN GUARD-Heart' (K.V.V.L., V.D., C.v.d.W., A.D., I.D., H.B., F.R.I.N., T.R., N.H., J.T., J.T.-H., V.P., A.L., H.S., P.J.S., A.A.M.W.).
Department of Cardiology, Royal Brompton Hospital, London, United Kingdom (F.R.I.N., J.T.).

Jonathan R Skinner (JR)

The Green Lane Paediatric and Congenital Cardiac Services, Starship Children's Hospital and Department of Paediatrics Child and Youth Health, University of Auckland, New Zealand (J.R.S.).

Jacob Tfelt-Hansen (J)

European Reference Network 'ERN GUARD-Heart' (K.V.V.L., V.D., C.v.d.W., A.D., I.D., H.B., F.R.I.N., T.R., N.H., J.T., J.T.-H., V.P., A.L., H.S., P.J.S., A.A.M.W.).
Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Denmark (J.T.-H.).
Department of Forensic Medicine, Faculty of Medical Sciences, University of Copenhagen, Denmark (J.T.-H.).

Vincent Probst (V)

European Reference Network 'ERN GUARD-Heart' (K.V.V.L., V.D., C.v.d.W., A.D., I.D., H.B., F.R.I.N., T.R., N.H., J.T., J.T.-H., V.P., A.L., H.S., P.J.S., A.A.M.W.).
l'institut du thorax, Service de Cardiologie du CHU de Nantes, Hopital Nord, Nantes Cedex, France (V.P.).

Antoine Leenhardt (A)

European Reference Network 'ERN GUARD-Heart' (K.V.V.L., V.D., C.v.d.W., A.D., I.D., H.B., F.R.I.N., T.R., N.H., J.T., J.T.-H., V.P., A.L., H.S., P.J.S., A.A.M.W.).
CNMR Maladies Cardiaques Héréditaires Rares, Hôpital Bichat, Paris, France (I.D., A.L.).
Université Paris Diderot, Sorbonne Paris Cité, France (I.D., A.L.).
AP-HP, Service de Cardiologie, Hôpital Bichat, Paris, France (I.D., A.L.).

Minoru Horie (M)

Department of Cardiovascular Medicine, Shiga University of Medical Science, Otsu, Japan (Y.W., M.H.).

Heikki Swan (H)

European Reference Network 'ERN GUARD-Heart' (K.V.V.L., V.D., C.v.d.W., A.D., I.D., H.B., F.R.I.N., T.R., N.H., J.T., J.T.-H., V.P., A.L., H.S., P.J.S., A.A.M.W.).
Heart and Lung Center, Helsinki University Hospital, Helsinki University, Finland (A.D., H.S.).

Jason D Roberts (JD)

Section of Cardiac Electrophysiology, Division of Cardiology, Departmentt of Medicine, Western University, London, ON, Canada (J.D.R.).

Shubhayan Sanatani (S)

Department of Pediatrics, Children's Heart Centre, Division of Cardiology, British Columbia Children's Hospital, Vancouver, BC, Canada (T.M.R., S.S.).

Kristina H Haugaa (KH)

Department of Cardiology, Center for Cardiological Innovation, Oslo University Hospital, Rikshospitalet, University of Oslo, Norway (M.K.S., K.H.H.).

Peter J Schwartz (PJ)

European Reference Network 'ERN GUARD-Heart' (K.V.V.L., V.D., C.v.d.W., A.D., I.D., H.B., F.R.I.N., T.R., N.H., J.T., J.T.-H., V.P., A.L., H.S., P.J.S., A.A.M.W.).
Center for Cardiac Arrhythmias of Genetic Origin, IRCCS Istituto Auxologico Italiano, Milan, Italy (P.J.S.).

Michael J Ackerman (MJ)

Department of Cardiovascular Medicine, Division of Heart Rhythm Services (J.M.B., C.M.L., M.J.A.), Mayo Clinic, Rochester, MN.
Department of Pediatric and Adolescent Medicine, Division of Pediatric Cardiology (J.M.B., C.M.L., M.J.A.), Mayo Clinic, Rochester, MN.
Department of Molecular Pharmacology and Experimental Therapeutics, Windland Smith Rice Sudden Death Genomics Laboratory (J.M.B., C.M.L., M.J.A.), Mayo Clinic, Rochester, MN.

Arthur A M Wilde (AAM)

Department of Clinical and Experimental Cardiology, Heart Center (K.V.V.L., C.v.d.W., N.H., S.-A.B.C., A.A.M.W.), the Netherlands.
European Reference Network 'ERN GUARD-Heart' (K.V.V.L., V.D., C.v.d.W., A.D., I.D., H.B., F.R.I.N., T.R., N.H., J.T., J.T.-H., V.P., A.L., H.S., P.J.S., A.A.M.W.).

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Classifications MeSH

questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Heart Rate Recovery After Exercise Is...
questionsmedicales.fr › Diagnostic › Techniques et procédures diagnostiques › Électrodiagnostic › Électrocardiographie › Heart Rate Recovery After Exercise Is...
questionsmedicales.fr › Activités humaines › Exercice physique › Heart Rate Recovery After Exercise Is...
questionsmedicales.fr › Techniques d'investigation › Ergométrie › Épreuve d'effort › Heart Rate Recovery After Exercise Is...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études de suivi › Heart Rate Recovery After Exercise Is...
questionsmedicales.fr › Phénomènes physiologiques respiratoires et circulatoires › Phénomènes physiologiques cardiovasculaires › Hémodynamique › Rythme cardiaque › Heart Rate Recovery After Exercise Is...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Heart Rate Recovery After Exercise Is...
questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Adulte d'âge moyen › Heart Rate Recovery After Exercise Is...
questionsmedicales.fr › Phénomènes biologiques › Récupération fonctionnelle › Heart Rate Recovery After Exercise Is...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études rétrospectives › Heart Rate Recovery After Exercise Is...
questionsmedicales.fr › États, signes et symptômes pathologiques › Processus pathologiques › Troubles du rythme cardiaque › Tachycardie › Tachycardie ventriculaire › Heart Rate Recovery After Exercise Is...
questionsmedicales.fr › Système nerveux › Système nerveux périphérique › Nerfs périphériques › Nerfs crâniens › Nerf vague › Heart Rate Recovery After Exercise Is...
questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Jeune adulte › Heart Rate Recovery After Exercise Is...