Arrhythmogenic response to isoproterenol testing vs. exercise testing in arrhythmogenic right ventricular cardiomyopathy patients

被引：23

作者：

Denis, A. ^{[1
]}

Sacher, F. ^{[1
]}

Derval, N. ^{[1
]}

Martin, R. ^{[1
]}

Lim, H. S. ^{[1
]}

Pambrun, T. ^{[1
]}

Massoullie, G. ^{[1
]}

Duchateau, J. ^{[1
]}

Cochet, H. ^{[1
]}

Pillois, X. ^{[1
]}

Cheniti, G. ^{[1
]}

Frontera, A. ^{[1
]}

Takigawa, M. ^{[1
]}

Vlachos, K. ^{[1
]}

Martin, C. ^{[1
]}

Kitamura, T. ^{[1
]}

Hocini, M. ^{[1
]}

Douard, H. ^{[1
]}

Jais, P. ^{[1
]}

Haissaguerre, M. ^{[1
]}

机构：

[1] Univ Bordeaux, Inst Rythmol & Modelisat Cardiaque, CHU Bordeaux, LIRYC,Hop Cardiol Haut Leveque, Bordeaux, France

来源：

EUROPACE | 2018年 / 20卷

关键词：

Arrhythmogenic right ventricular cardiomyopathy/dysplasia; Ventricular arrhythmias; Diagnosis; Isoproterenol; Exercise testing; DESMOSOMAL MUTATION CARRIERS; AMERICAN-HEART-ASSOCIATION; HIGH-DOSE ISOPROTERENOL; COLLEGE-OF-CARDIOLOGY; TERM-FOLLOW-UP; DISQUALIFICATION RECOMMENDATIONS; SCIENTIFIC STATEMENT; DYSPLASIA/CARDIOMYOPATHY; DYSPLASIA; ELIGIBILITY;

D O I：

10.1093/europace/euy007

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Aims To compare the arrhythmic response to isoproterenol and exercise testing in newly diagnosed arrhythmogenic right ventricular cardiomyopathy (ARVC) patients. Methods and results We studied isoproterenol [continuous infusion (45 mg/min) for 3 min] and exercise testing (workload increased by 30W every 3 min) performed in consecutive newly diagnosed ARVC patients. Both tests were evaluated with regard to the incidence of (i) polymorphic premature ventricular contractions (PVCs) and couplet(s) or (ii) sustained or non-sustained ventricular tachycardia (VT) with left bundle branch block [excluding right ventricular outflow tract VT]; and compared to a control group referred for the evaluation of PVCs without structural heart disease. Thirty-seven ARVC patients (63.5% male, age 38 +/- 16 years) were included. The maximal sinus rhythm heart rate achieved during isoproterenol testing was significantly lower compared to exercise testing (149 +/- 17 bpm vs. 166 +/- 19 bpm, P < 0.0001). However, the incidence of polymorphic ventricular arrhythmias was much higher during isoproterenol testing compared to exercise testing [33/37 (89.2%) vs. 16/37 (43.2%), P < 0.0001]. Interestingly, isoproterenol testing was arrhythmogenic in all 15 patients in whom baseline PVCs were reduced or suppressed during exercise testing. During both isoproterenol and exercise testing, control group presented a low incidence of ventricular arrhythmias compared to ARVC patients (8.1% vs. 89.2%, P < 0.0001 and 2.7% vs. 43.2%, P < 0.0001, respectively). Conclusions The incidence of polymorphic ventricular arrhythmias is significantly higher during isoproterenol compared to exercise testing in newly diagnosed ARVC patients, suggesting its potential utility for the diagnosis.

引用

页码：F30 / F36

页数：7

共 23 条

[1] High-Dose Isoproterenol Testing for Diagnosis of Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy Is There a Role? [J].