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Precision Medicine Approaches to Cardiac Arrhythmias: JACC Focus Seminar 4/5
John R Giudicessi1, Michael J Ackerman2, Diane Fatkin3
1Department of Cardiovascular Medicine, Clinician-Investigator Training Program, Mayo Clinic, Rochester, Minnesota, USA; Department of Cardiovascular Medicine, Division of Heart Rhythm Services and Windland Smith Rice Genetic Heart Rhythm Clinic, Mayo Clinic, Rochester, Minnesota, USA.
Insights
Precision medicine advances for arrhythmias like long QT syndrome, Brugada syndrome, and atrial fibrillation utilize genetic testing and personalized risk stratification. These approaches aim to tailor therapies and avoid triggers for better patient outcomes.
Area of Science:
- Cardiology
- Genetics
- Precision Medicine
Background:
- Previous papers covered precision medicine fundamentals, vascular disease, and cardiomyopathy.
- This paper continues the series by focusing on precision medicine in cardiac arrhythmias.
Purpose of the Study:
- To review precision medicine approaches for specific arrhythmias: long QT syndrome, Brugada syndrome, and atrial fibrillation.
- To highlight common themes in precision medicine for these conditions.
Main Methods:
- Review of current literature and emerging precision medicine strategies.
- Analysis of genetic and environmental factors contributing to arrhythmias.
- Examination of clinical manifestations and treatment approaches.
Main Results:
- Precision medicine for these arrhythmias involves increased genetic testing.
- Strategies include avoiding specific triggers and personalized risk stratification.
- Therapies are increasingly tailored to individual patient profiles.
Conclusions:
- Precision medicine offers varied but promising approaches for managing long QT syndrome, Brugada syndrome, and atrial fibrillation.
- Genetic insights and personalized strategies are key to improving outcomes and preventing severe consequences.
Abstract:
In the initial 3 papers in this Focus Seminar series, the fundamentals and key concepts of precision medicine were reviewed, followed by a focus on precision medicine in the context of vascular disease and cardiomyopathy. For the remaining 2 papers, we focus on precision medicine in the context of arrhythmias. Specifically, in this fourth paper we focus on long QT syndrome, Brugada syndrome, and atrial fibrillation. The final (fifth) paper will deal with catecholaminergic polymorphic ventricular tachycardia. These arrhythmias represent a spectrum of disease ranging from common to relatively rare, with very different genetic and environmental causative factors, and with differing clinical manifestations that range from almost no consequences to lethality in childhood or adolescence if untreated. Accordingly, the emerging precision medicine approaches to these arrhythmias vary significantly, but several common themes include increased use of genetic testing, avoidance of triggers, and personalized risk stratification to guide the use of arrhythmia-specific therapies.
