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Channelopathies - emerging trends in the management of inherited arrhythmias.

Chockalingam P, Mizusawa Y, Wilde AA - Indian Pacing Electrophysiol J (2015)

Bottom Line: This has been made possible by the vast advances in the field of molecular biology enabling better understanding of the genetic underpinnings of some of these disease groups, namely congenital long QT syndrome, catecholaminergic polymorphic ventricular tachycardia and Brugada syndrome.The various diagnostic modalities currently available to us, including clinical tools and genetic technologies, have to be applied judiciously in order to promptly identify those affected and to spare the emotional burden of a potentially lethal disease in the unaffected individuals.A treatment strategy keeping in mind the risk profile of the patients, the local availability of drugs and the expertise of the treating personnel is proving effective.

View Article: PubMed Central - PubMed

Affiliation: Cardiac Wellness Institute, Chennai, India.

ABSTRACT
In spite of their relative rarity, inheritable arrhythmias have come to the forefront as a group of potentially fatal but preventable cause of sudden cardiac death in children and (young) adults. Comprehensive management of inherited arrhythmias includes diagnosing and treating the proband and identifying and protecting affected family members. This has been made possible by the vast advances in the field of molecular biology enabling better understanding of the genetic underpinnings of some of these disease groups, namely congenital long QT syndrome, catecholaminergic polymorphic ventricular tachycardia and Brugada syndrome. The ensuing knowledge of the genotype-phenotype correlations enables us to risk-stratify, prognosticate and treat based on the genetic test results. The various diagnostic modalities currently available to us, including clinical tools and genetic technologies, have to be applied judiciously in order to promptly identify those affected and to spare the emotional burden of a potentially lethal disease in the unaffected individuals. The therapeutic armamentarium of inherited arrhythmias includes pharmacological agents, device therapies and surgical interventions. A treatment strategy keeping in mind the risk profile of the patients, the local availability of drugs and the expertise of the treating personnel is proving effective. While opportunities for research are numerous in this expanding field of medicine, there is also tremendous scope for incorporating the emerging trends in managing patients and families with inherited arrhythmias in the Indian subcontinent.

No MeSH data available.


Related in: MedlinePlus

ECGs during exercise testing before and after drug treatments in a 31-year old female with CVPT. At baseline before medication (A), NSVT and bouts of VES were observed. After metoprolol (100mg/day), frequent VES still appeared during the test. With metoprolol (100mg/day) and flecainide (150mg/day), ventricular arrhythmias were suppressed and only a few VES were recorded throughout the test. Notably, there is no QRS prolongation during exercise on flecainide therapy. ECG=electrocardiogram; NSVT=non-sustained ventricular tachycardia; CPVT=catecholaminergic polymorphic ventricular tachycardia; VES=ventricular extrasystoles.
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Figure 4: ECGs during exercise testing before and after drug treatments in a 31-year old female with CVPT. At baseline before medication (A), NSVT and bouts of VES were observed. After metoprolol (100mg/day), frequent VES still appeared during the test. With metoprolol (100mg/day) and flecainide (150mg/day), ventricular arrhythmias were suppressed and only a few VES were recorded throughout the test. Notably, there is no QRS prolongation during exercise on flecainide therapy. ECG=electrocardiogram; NSVT=non-sustained ventricular tachycardia; CPVT=catecholaminergic polymorphic ventricular tachycardia; VES=ventricular extrasystoles.


Channelopathies - emerging trends in the management of inherited arrhythmias.

Chockalingam P, Mizusawa Y, Wilde AA - Indian Pacing Electrophysiol J (2015)

ECGs during exercise testing before and after drug treatments in a 31-year old female with CVPT. At baseline before medication (A), NSVT and bouts of VES were observed. After metoprolol (100mg/day), frequent VES still appeared during the test. With metoprolol (100mg/day) and flecainide (150mg/day), ventricular arrhythmias were suppressed and only a few VES were recorded throughout the test. Notably, there is no QRS prolongation during exercise on flecainide therapy. ECG=electrocardiogram; NSVT=non-sustained ventricular tachycardia; CPVT=catecholaminergic polymorphic ventricular tachycardia; VES=ventricular extrasystoles.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4380694&req=5

Figure 4: ECGs during exercise testing before and after drug treatments in a 31-year old female with CVPT. At baseline before medication (A), NSVT and bouts of VES were observed. After metoprolol (100mg/day), frequent VES still appeared during the test. With metoprolol (100mg/day) and flecainide (150mg/day), ventricular arrhythmias were suppressed and only a few VES were recorded throughout the test. Notably, there is no QRS prolongation during exercise on flecainide therapy. ECG=electrocardiogram; NSVT=non-sustained ventricular tachycardia; CPVT=catecholaminergic polymorphic ventricular tachycardia; VES=ventricular extrasystoles.
Bottom Line: This has been made possible by the vast advances in the field of molecular biology enabling better understanding of the genetic underpinnings of some of these disease groups, namely congenital long QT syndrome, catecholaminergic polymorphic ventricular tachycardia and Brugada syndrome.The various diagnostic modalities currently available to us, including clinical tools and genetic technologies, have to be applied judiciously in order to promptly identify those affected and to spare the emotional burden of a potentially lethal disease in the unaffected individuals.A treatment strategy keeping in mind the risk profile of the patients, the local availability of drugs and the expertise of the treating personnel is proving effective.

View Article: PubMed Central - PubMed

Affiliation: Cardiac Wellness Institute, Chennai, India.

ABSTRACT
In spite of their relative rarity, inheritable arrhythmias have come to the forefront as a group of potentially fatal but preventable cause of sudden cardiac death in children and (young) adults. Comprehensive management of inherited arrhythmias includes diagnosing and treating the proband and identifying and protecting affected family members. This has been made possible by the vast advances in the field of molecular biology enabling better understanding of the genetic underpinnings of some of these disease groups, namely congenital long QT syndrome, catecholaminergic polymorphic ventricular tachycardia and Brugada syndrome. The ensuing knowledge of the genotype-phenotype correlations enables us to risk-stratify, prognosticate and treat based on the genetic test results. The various diagnostic modalities currently available to us, including clinical tools and genetic technologies, have to be applied judiciously in order to promptly identify those affected and to spare the emotional burden of a potentially lethal disease in the unaffected individuals. The therapeutic armamentarium of inherited arrhythmias includes pharmacological agents, device therapies and surgical interventions. A treatment strategy keeping in mind the risk profile of the patients, the local availability of drugs and the expertise of the treating personnel is proving effective. While opportunities for research are numerous in this expanding field of medicine, there is also tremendous scope for incorporating the emerging trends in managing patients and families with inherited arrhythmias in the Indian subcontinent.

No MeSH data available.


Related in: MedlinePlus