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Published on: December 22, 2023
Pediatric Catecholaminergic Polymorphic Ventricular Tachycardia: A Translational Perspective for the
Dania Kallas1, Avani Lamba1, Thomas M Roston1,2
1British Columbia Children's Hospital Heart Center, 1F9-4480 Oak St., Vancouver, BC V6H 3V4, Canada.
Insights
Catecholaminergic polymorphic ventricular tachycardia (CPVT) is a rare inherited heart rhythm disorder. This review summarizes pediatric CPVT data, identifies knowledge gaps, and suggests future research directions for this serious condition.
Area of Science:
- Cardiology
- Genetics
- Pediatric Electrophysiology
Background:
- Catecholaminergic polymorphic ventricular tachycardia (CPVT) is a rare, life-threatening inherited arrhythmia.
- It is triggered by exercise or emotion, causing ventricular tachyarrhythmias.
- Genetic variants in cardiac ryanodine receptors or calsequestrin 2 are common causes, leading to calcium mishandling in heart cells.
Purpose of the Study:
- To review current knowledge on pediatric CPVT.
- To identify gaps in understanding and treatment.
- To propose future research avenues for clinicians and scientists.
Main Methods:
- This is a review article.
- It synthesizes contemporary data on pediatric CPVT.
- It focuses on knowledge gaps and future research directions.
Main Results:
- Pediatric CPVT often presents with severe symptoms like cardiac arrest and syncope.
- Disease onset is typically around age 10.
- Genetic mutations disrupt calcium handling in cardiomyocytes, leading to arrhythmias.
Conclusions:
- Pediatric CPVT is a severe condition with imprecise risk stratification and unknown long-term prognosis.
- Further research is crucial to improve understanding and management of pediatric CPVT.
- Future directions should focus on addressing current knowledge gaps in this population.
Abstract:
Catecholaminergic polymorphic ventricular tachycardia (CPVT) is a rare and potentially lethal inherited arrhythmia disease characterized by exercise or emotion-induced bidirectional or polymorphic ventricular tachyarrhythmias. The median age of disease onset is reported to be approximately 10 years of age. The majority of CPVT patients have pathogenic variants in the gene encoding the cardiac ryanodine receptor, or calsequestrin 2. These lead to mishandling of calcium in cardiomyocytes resulting in after-depolarizations, and ventricular arrhythmias. Disease severity is particularly pronounced in younger individuals who usually present with cardiac arrest and arrhythmic syncope. Risk stratification is imprecise and long-term prognosis on therapy is unknown despite decades of research focused on pediatric CPVT populations. The purpose of this review is to summarize contemporary data on pediatric CPVT, highlight knowledge gaps and present future research directions for the clinician-scientist to address.
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