Importance of exercise stress testing in evaluation of unexplained cardiac arrest survivor.

CPVT Exercise stress testing Sudden cardiac arrest

Journal

Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation
ISSN: 1568-5888
Titre abrégé: Neth Heart J
Pays: Netherlands
ID NLM: 101095458

Informations de publication

Date de publication:
Nov 2023
Historique:
accepted: 18 04 2023
medline: 22 6 2023
pubmed: 22 6 2023
entrez: 22 6 2023
Statut: ppublish

Résumé

In sudden cardiac arrest survivors without an immediately identifiable cause, additional extensive yet individualised testing is required. We describe 3 survivors of sudden cardiac arrest in whom exercise stress testing was not performed during the initial hospital admission. All 3 patients were incorrectly diagnosed with long QT syndrome based on temporary sudden cardiac arrest-related heart rate-corrected QT interval prolongation, and exercise stress testing was not performed during the initial work-up. When they were subjected to exercise stress testing during follow-up, a delayed diagnosis of catecholaminergic polymorphic ventricular tachycardia (CPVT) was made. As a result, these patients were initially managed inappropriately, and their family members were initially not screened for CPVT. In sudden cardiac arrest survivors without an immediately identifiable cause, omission of exercise stress testing or erroneous interpretation of the results can lead to a delayed or missed diagnosis of CPVT, which may have considerable implications for survivors and their family.

Sections du résumé

BACKGROUND BACKGROUND
In sudden cardiac arrest survivors without an immediately identifiable cause, additional extensive yet individualised testing is required.
METHODS METHODS
We describe 3 survivors of sudden cardiac arrest in whom exercise stress testing was not performed during the initial hospital admission.
RESULTS RESULTS
All 3 patients were incorrectly diagnosed with long QT syndrome based on temporary sudden cardiac arrest-related heart rate-corrected QT interval prolongation, and exercise stress testing was not performed during the initial work-up. When they were subjected to exercise stress testing during follow-up, a delayed diagnosis of catecholaminergic polymorphic ventricular tachycardia (CPVT) was made. As a result, these patients were initially managed inappropriately, and their family members were initially not screened for CPVT.
CONCLUSION CONCLUSIONS
In sudden cardiac arrest survivors without an immediately identifiable cause, omission of exercise stress testing or erroneous interpretation of the results can lead to a delayed or missed diagnosis of CPVT, which may have considerable implications for survivors and their family.

Identifiants

pubmed: 37347419
doi: 10.1007/s12471-023-01789-w
pii: 10.1007/s12471-023-01789-w
pmc: PMC10602994
doi:

Types de publication

Journal Article

Langues

eng

Pagination

444-451

Subventions

Organisme : ZonMw
ID : 113304045
Pays : Netherlands

Informations de copyright

© 2023. The Author(s).

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Auteurs

Auke T Bergeman (AT)

Heart Centre, Department of Cardiology, Amsterdam University Medical Centres, location Academic Medical Centre, Amsterdam, The Netherlands.
European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart (ERN GUARD-Heart), Brussels, Belgium.
Amsterdam Cardiovascular Sciences, Heart Failure and Arrhythmias, Amsterdam, The Netherlands.

Tomas Robyns (T)

European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart (ERN GUARD-Heart), Brussels, Belgium.
Department of Cardiovascular Diseases, University Hospitals Leuven, Leuven, Belgium.

Ahmad S Amin (AS)

Heart Centre, Department of Cardiology, Amsterdam University Medical Centres, location Academic Medical Centre, Amsterdam, The Netherlands.
European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart (ERN GUARD-Heart), Brussels, Belgium.
Amsterdam Cardiovascular Sciences, Heart Failure and Arrhythmias, Amsterdam, The Netherlands.

Arthur A M Wilde (AAM)

Heart Centre, Department of Cardiology, Amsterdam University Medical Centres, location Academic Medical Centre, Amsterdam, The Netherlands.
European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart (ERN GUARD-Heart), Brussels, Belgium.
Amsterdam Cardiovascular Sciences, Heart Failure and Arrhythmias, Amsterdam, The Netherlands.

Christian van der Werf (C)

Heart Centre, Department of Cardiology, Amsterdam University Medical Centres, location Academic Medical Centre, Amsterdam, The Netherlands. c.vanderwerf@amsterdamumc.nl.
European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart (ERN GUARD-Heart), Brussels, Belgium. c.vanderwerf@amsterdamumc.nl.
Amsterdam Cardiovascular Sciences, Heart Failure and Arrhythmias, Amsterdam, The Netherlands. c.vanderwerf@amsterdamumc.nl.

Classifications MeSH