Document Detail


Utility of exercise testing in children and teenagers with arrhythmogenic right ventricular cardiomyopathy.
MedLine Citation:
PMID:  19616676     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Arrhythmogenic right ventricular cardiomyopathy (ARVC) is increasingly recognized as an important cause of exertional sudden death in otherwise healthy young individuals and athletes. Graded exercise testing is routinely included in the evaluation of patients with suspected ARVC, but its diagnostic utility has not been systematically assessed. Using a single-center retrospective design, the rhythm response to graded exercise testing was examined in 33 tests performed in 16 young (aged <18 years) patients with established diagnosis of ARVC. Ventricular premature complexes (VPCs) were classified as absent (graded 0), as being isolated or in couplets (graded 1), or as comprising nonsustained ventricular tachycardia (graded 2) during pretest rest, at peak exercise, and during postexercise recovery. VPCs were absent at rest in 21 of 33 studies, subsequently appearing at peak exercise in 4 studies and during recovery in 2 studies. Isolated VPCs and couplets were present at rest in 9 of 33 studies, with subsequent exercise provoking higher grade ectopic activity in 2 instances at peak exercise and in 1 case during recovery, while VPCs decreased or remained unchanged in all other cases. In all 3 instances in which ventricular tachycardia was observed during pretest rest, there was either suppression (3 at peak exercise, 2 during recovery) or no change (1 case during recovery) in VPC grade. In conclusion, the exercise response of ventricular ectopic activity is highly variable in young patients with ARVC. The diagnostic utility of graded exercise testing is thus questionable in young patients with suspected ARVC, and the absence or suppression of VPCs during exercise should not be considered reassuring in terms of its diagnostic exclusion.
Authors:
Ilan Buffo Sequeira; Joel A Kirsh; Robert M Hamilton; Jennifer L Russell; Gil J Gross
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Publication Detail:
Type:  Journal Article     Date:  2009-06-06
Journal Detail:
Title:  The American journal of cardiology     Volume:  104     ISSN:  1879-1913     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2009 Aug 
Date Detail:
Created Date:  2009-07-20     Completed Date:  2009-08-31     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  411-3     Citation Subset:  AIM; IM    
Affiliation:
Department of Paediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Arrhythmogenic Right Ventricular Dysplasia / diagnosis*
Child
Exercise Test / statistics & numerical data*
Female
Humans
Male
Retrospective Studies

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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