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Long-Term Serial Exercise Stress Testing in Catecholaminergic Polymorphic Ventricular Tachycardia on Beta-Blocker and
Fernando Wangüemert-Perez1, German Ostos-Cañero1, Marta Wangüemert-Guerra1
1Cardiavant, Centro Médico Cardiológico, Las Palmas de Gran Canaria, Spain.
Journal of Cardiovascular Electrophysiology
|June 30, 2026
Summary
Adding flecainide to beta-blocker therapy significantly reduces ventricular arrhythmias in catecholaminergic polymorphic ventricular tachycardia (CPVT) patients. This combination therapy improves exercise tolerance and is well-tolerated long-term.
Area of Science:
- Cardiology
- Genetics
- Pharmacology
Background:
- Catecholaminergic polymorphic ventricular tachycardia (CPVT) is a life-threatening disorder.
- Current treatments include beta-blockers and flecainide.
Purpose of the Study:
- To evaluate the efficacy and safety of adding flecainide to beta-blocker therapy in CPVT patients.
- To assess the long-term impact on arrhythmic burden and exercise parameters.
Main Methods:
- Genetic testing for RyR2 mutation carriers.
- Assessment of ventricular arrhythmias using scoring systems.
- Progressive titration of flecainide in combination with beta-blockers.
Main Results:
- Flecainide was well-tolerated in 32 CPVT patients requiring combination therapy.
- Significant reduction in both qualitative and quantitative arrhythmic scores post-flecainide initiation.
- Improved exercise-related parameters including reduced heart rate and increased metabolic equivalents.
Conclusions:
- Combination therapy with flecainide and beta-blockers is effective for managing CPVT.
- This approach significantly reduces arrhythmic burden and improves exercise capacity.
- Long-term follow-up demonstrates sustained benefits and good tolerability.
Keywords:
beta‐blockerscatecholaminergic polymorphic ventricular tachycardia (CPVT)exercise capacityflecainidetreadmill ergometryMore Related Videos
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