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Polymorphic ventricular tachycardia

MedGen UID:
138002
Concept ID:
C0344432
Disease or Syndrome
Synonyms: Polymorphic Ventricular Tachycardia; polymorphic ventricular tachycardia; Ventricular tachycardia, polymorphic; ventricular tachycardia, polymorphic
SNOMED CT: Ventricular tachycardia, polymorphic (251159007)
 
HPO: HP:0031677
Monarch Initiative: MONDO:0020575

Definition

A type of ventricular tachycardia that is characterized by variable QRS complexes within each lead (i.e., QRS complexes may be different from beat to beat). [from HPO]

Conditions with this feature

Sick sinus syndrome 2, autosomal dominant
MedGen UID:
320273
Concept ID:
C1834144
Disease or Syndrome
Sick sinus syndrome (also known as sinus node dysfunction) is a group of related heart conditions that can affect how the heart beats. "Sick sinus" refers to the sino-atrial (SA) node, which is an area of specialized cells in the heart that functions as a natural pacemaker. The SA node generates electrical impulses that start each heartbeat. These signals travel from the SA node to the rest of the heart, signaling the heart (cardiac) muscle to contract and pump blood. In people with sick sinus syndrome, the SA node does not function normally. In some cases, it does not produce the right signals to trigger a regular heartbeat. In others, abnormalities disrupt the electrical impulses and prevent them from reaching the rest of the heart.\n\nSick sinus syndrome occurs most commonly in older adults, although it can be diagnosed in people of any age. The condition increases the risk of several life-threatening problems involving the heart and blood vessels. These include a heart rhythm abnormality called atrial fibrillation, heart failure, cardiac arrest, and stroke.\n\nSick sinus syndrome tends to cause the heartbeat to be too slow (bradycardia), although occasionally the heartbeat is too fast (tachycardia). In some cases, the heartbeat rapidly switches from being too fast to being too slow, a condition known as tachycardia-bradycardia syndrome. Symptoms related to abnormal heartbeats can include dizziness, light-headedness, fainting (syncope), a sensation of fluttering or pounding in the chest (palpitations), and confusion or memory problems. During exercise, many affected individuals experience chest pain, difficulty breathing, or excessive tiredness (fatigue). Once symptoms of sick sinus syndrome appear, they usually worsen with time. However, some people with the condition never experience any related health problems.
Catecholaminergic polymorphic ventricular tachycardia 2
MedGen UID:
393837
Concept ID:
C2677794
Disease or Syndrome
Catecholaminergic polymorphic ventricular tachycardia (CPVT) is characterized by episodic syncope occurring during exercise or acute emotion. The underlying cause of these episodes is the onset of fast ventricular tachycardia (bidirectional or polymorphic). Spontaneous recovery may occur when these arrhythmias self-terminate. In other instances, ventricular tachycardia may degenerate into ventricular fibrillation and cause sudden death if cardiopulmonary resuscitation is not readily available. The mean onset of symptoms (usually a syncopal episode) is between age seven and 12 years; onset as late as the fourth decade of life has been reported. If untreated, CPVT is highly lethal, as approximately 30% of affected individuals experience at least one cardiac arrest and up to 80% have one or more syncopal spells. Sudden death may be the first manifestation of the disease.
Catecholaminergic polymorphic ventricular tachycardia 3
MedGen UID:
462813
Concept ID:
C3151463
Disease or Syndrome
Catecholaminergic polymorphic ventricular tachycardia (CPVT) is characterized by episodic syncope occurring during exercise or acute emotion. The underlying cause of these episodes is the onset of fast ventricular tachycardia (bidirectional or polymorphic). Spontaneous recovery may occur when these arrhythmias self-terminate. In other instances, ventricular tachycardia may degenerate into ventricular fibrillation and cause sudden death if cardiopulmonary resuscitation is not readily available. The mean onset of symptoms (usually a syncopal episode) is between age seven and 12 years; onset as late as the fourth decade of life has been reported. If untreated, CPVT is highly lethal, as approximately 30% of affected individuals experience at least one cardiac arrest and up to 80% have one or more syncopal spells. Sudden death may be the first manifestation of the disease.
Catecholaminergic polymorphic ventricular tachycardia 5
MedGen UID:
815866
Concept ID:
C3809536
Disease or Syndrome
Catecholaminergic polymorphic ventricular tachycardia (CPVT) is characterized by episodic syncope occurring during exercise or acute emotion. The underlying cause of these episodes is the onset of fast ventricular tachycardia (bidirectional or polymorphic). Spontaneous recovery may occur when these arrhythmias self-terminate. In other instances, ventricular tachycardia may degenerate into ventricular fibrillation and cause sudden death if cardiopulmonary resuscitation is not readily available. The mean onset of symptoms (usually a syncopal episode) is between age seven and 12 years; onset as late as the fourth decade of life has been reported. If untreated, CPVT is highly lethal, as approximately 30% of affected individuals experience at least one cardiac arrest and up to 80% have one or more syncopal spells. Sudden death may be the first manifestation of the disease.
Long QT syndrome 14
MedGen UID:
864108
Concept ID:
C4015671
Disease or Syndrome
LQT14 is a cardiac arrhythmia disorder characterized by ventricular arrhythmias, often life-threatening, occurring very early in life, frequent episodes of T-wave alternans, markedly prolonged QTc intervals, and intermittent 2:1 atrioventricular block (Crotti et al., 2013). Patients with LQT14, LQT15 (616249), or LQT16 (618782), resulting from mutation in calmodulin genes CALM1, CALM2 (114182), or CALM3 (114183), respectively, typically have a more severe phenotype, with earlier onset, profound QT prolongation, and a high predilection for cardiac arrest and sudden death, than patients with mutations in other genes (Boczek et al., 2016).
Long QT syndrome 15
MedGen UID:
864132
Concept ID:
C4015695
Disease or Syndrome
LQT15 is a cardiac arrhythmia disorder characterized by ventricular arrhythmias, often life-threatening, occurring very early in life, frequent episodes of T-wave alternans, markedly prolonged QTc intervals, and intermittent 2:1 atrioventricular block (Crotti et al., 2013). Patients with LQT14 (616247), LQT15, or LQT16 (618782), resulting from mutation in calmodulin genes CALM1 (114180), CALM2, or CALM3 (114183), respectively, typically have a more severe phenotype, with earlier onset, profound QT prolongation, and a high predilection for cardiac arrest and sudden death, than patients with mutations in other genes (Boczek et al., 2016).

Professional guidelines

PubMed

Writing Committee Members, Shah MJ, Silka MJ, Silva JNA, Balaji S, Beach CM, Benjamin MN, Berul CI, Cannon B, Cecchin F, Cohen MI, Dalal AS, Dechert BE, Foster A, Gebauer R, Gonzalez Corcia MC, Kannankeril PJ, Karpawich PP, Kim JJ, Krishna MR, Kubuš P, LaPage MJ, Mah DY, Malloy-Walton L, Miyazaki A, Motonaga KS, Niu MC, Olen M, Paul T, Rosenthal E, Saarel EV, Silvetti MS, Stephenson EA, Tan RB, Triedman J, Bergen NHV, Wackel PL
Heart Rhythm 2021 Nov;18(11):1888-1924. Epub 2021 Jul 29 doi: 10.1016/j.hrthm.2021.07.038. PMID: 34363988
Pflaumer A, Davis AM
Heart Lung Circ 2019 Mar;28(3):366-369. Epub 2018 Nov 7 doi: 10.1016/j.hlc.2018.10.016. PMID: 30446242
Kloesel B, Ackerman MJ, Sprung J, Narr BJ, Weingarten TN
Can J Anaesth 2011 Sep;58(9):824-36. Epub 2011 Jun 23 doi: 10.1007/s12630-011-9546-y. PMID: 21698509

Recent clinical studies

Etiology

Tfelt-Hansen J, Garcia R, Albert C, Merino J, Krahn A, Marijon E, Basso C, Wilde AAM, Haugaa KH
Europace 2023 Aug 25;25(8) doi: 10.1093/europace/euad203. PMID: 37622576Free PMC Article
Mazzanti A, Kukavica D, Trancuccio A, Memmi M, Bloise R, Gambelli P, Marino M, Ortíz-Genga M, Morini M, Monteforte N, Giordano U, Keegan R, Tomasi L, Anastasakis A, Davis AM, Shimizu W, Blom NA, Santiago DJ, Napolitano C, Monserrat L, Priori SG
JAMA Cardiol 2022 May 1;7(5):504-512. doi: 10.1001/jamacardio.2022.0219. PMID: 35353122Free PMC Article
Rojas R, Kaul R, Frenkel D, Hoch EG, Iwai S, Jacobson JT, Aronow WS
Hosp Pract (1995) 2021 Oct;49(4):255-261. Epub 2021 Mar 30 doi: 10.1080/21548331.2021.1906012. PMID: 33730522
Etchegoyen CV, Keller GA, Mrad S, Cheng S, Di Girolamo G
Curr Clin Pharmacol 2017;12(4):210-222. doi: 10.2174/1574884713666180223123947. PMID: 29473523
McKenna WJ, Maron BJ, Thiene G
Circ Res 2017 Sep 15;121(7):722-730. doi: 10.1161/CIRCRESAHA.117.309711. PMID: 28912179

Diagnosis

Kallas D, Roberts JD, Sanatani S, Roston TM
Card Electrophysiol Clin 2023 Sep;15(3):319-329. Epub 2023 Jun 20 doi: 10.1016/j.ccep.2023.05.003. PMID: 37558302
Kim JA, Chelu MG
Tex Heart Inst J 2021 Sep 1;48(4) doi: 10.14503/THIJ-20-7482. PMID: 34669951Free PMC Article
Viskin S, Chorin E, Viskin D, Hochstadt A, Schwartz AL, Rosso R
Circulation 2021 Sep 7;144(10):823-839. doi: 10.1161/CIRCULATIONAHA.121.055783. PMID: 34491774
McKenna WJ, Maron BJ, Thiene G
Circ Res 2017 Sep 15;121(7):722-730. doi: 10.1161/CIRCRESAHA.117.309711. PMID: 28912179
Leenhardt A, Denjoy I, Guicheney P
Circ Arrhythm Electrophysiol 2012 Oct;5(5):1044-52. Epub 2012 Sep 27 doi: 10.1161/CIRCEP.111.962027. PMID: 23022705

Therapy

Kallas D, Roberts JD, Sanatani S, Roston TM
Card Electrophysiol Clin 2023 Sep;15(3):319-329. Epub 2023 Jun 20 doi: 10.1016/j.ccep.2023.05.003. PMID: 37558302
Mazzanti A, Kukavica D, Trancuccio A, Memmi M, Bloise R, Gambelli P, Marino M, Ortíz-Genga M, Morini M, Monteforte N, Giordano U, Keegan R, Tomasi L, Anastasakis A, Davis AM, Shimizu W, Blom NA, Santiago DJ, Napolitano C, Monserrat L, Priori SG
JAMA Cardiol 2022 May 1;7(5):504-512. doi: 10.1001/jamacardio.2022.0219. PMID: 35353122Free PMC Article
Rojas R, Kaul R, Frenkel D, Hoch EG, Iwai S, Jacobson JT, Aronow WS
Hosp Pract (1995) 2021 Oct;49(4):255-261. Epub 2021 Mar 30 doi: 10.1080/21548331.2021.1906012. PMID: 33730522
Etchegoyen CV, Keller GA, Mrad S, Cheng S, Di Girolamo G
Curr Clin Pharmacol 2017;12(4):210-222. doi: 10.2174/1574884713666180223123947. PMID: 29473523
Leenhardt A, Denjoy I, Guicheney P
Circ Arrhythm Electrophysiol 2012 Oct;5(5):1044-52. Epub 2012 Sep 27 doi: 10.1161/CIRCEP.111.962027. PMID: 23022705

Prognosis

Pérez-Riera AR, Barbosa-Barros R, Samesina N, Pastore CA, Scanavacca M, Daminello-Raimundo R, de Abreu LC, Nikus K, Brugada P
Cardiol Rev 2021 Jul-Aug 01;29(4):165-177. doi: 10.1097/CRD.0000000000000326. PMID: 32947483
Kline J, Costantini O
Med Clin North Am 2019 Sep;103(5):809-820. doi: 10.1016/j.mcna.2019.05.001. PMID: 31378327
McKenna WJ, Maron BJ, Thiene G
Circ Res 2017 Sep 15;121(7):722-730. doi: 10.1161/CIRCRESAHA.117.309711. PMID: 28912179
Choudhuri I, Pinninti M, Marwali MR, Sra J, Akhtar M
Curr Probl Cardiol 2013 Dec;38(12):503-48. doi: 10.1016/j.cpcardiol.2013.07.004. PMID: 24262155
van der Werf C, Wilde AA
Heart 2013 Apr;99(7):497-504. Epub 2013 Feb 6 doi: 10.1136/heartjnl-2012-302033. PMID: 23390049

Clinical prediction guides

Pérez-Riera AR, Barbosa-Barros R, Samesina N, Pastore CA, Scanavacca M, Daminello-Raimundo R, de Abreu LC, Nikus K, Brugada P
Cardiol Rev 2021 Jul-Aug 01;29(4):165-177. doi: 10.1097/CRD.0000000000000326. PMID: 32947483
Lieve KV, Wilde AA
Europace 2015 Oct;17 Suppl 2:ii1-6. doi: 10.1093/europace/euv105. PMID: 26842110
Rhodes T, Weiss R
Card Electrophysiol Clin 2015 Sep;7(3):479-86. Epub 2015 Jul 8 doi: 10.1016/j.ccep.2015.05.018. PMID: 26304528
van der Werf C, Wilde AA
Heart 2013 Apr;99(7):497-504. Epub 2013 Feb 6 doi: 10.1136/heartjnl-2012-302033. PMID: 23390049
Abriel H, Zaklyazminskaya EV
Gene 2013 Mar 15;517(1):1-11. Epub 2012 Dec 22 doi: 10.1016/j.gene.2012.12.061. PMID: 23266818

Recent systematic reviews

Lawley CM, Tester M, Sanatani S, Prendiville T, Beach CM, Vinocur JM, Horie M, Uhm JS, Khongphatthanayothin A, Ayers MD, Starling L, Yoshida Y, Shah MJ, Skinner JR, Turner C
Heart Rhythm 2022 Nov;19(11):1826-1833. Epub 2022 Oct 11 doi: 10.1016/j.hrthm.2022.08.003. PMID: 37850595
Wang G, Zhao N, Zhong S, Wang Y, Li J
Medicine (Baltimore) 2019 Aug;98(34):e16961. doi: 10.1097/MD.0000000000016961. PMID: 31441899Free PMC Article
Roston TM, Jones K, Hawkins NM, Bos JM, Schwartz PJ, Perry F, Ackerman MJ, Laksman ZWM, Kaul P, Lieve KVV, Atallah J, Krahn AD, Sanatani S
Heart Rhythm 2018 Dec;15(12):1791-1799. Epub 2018 Jul 3 doi: 10.1016/j.hrthm.2018.06.046. PMID: 30063211
Refaat MM, Hotait M, Tseng ZH
Ann Noninvasive Electrocardiol 2014 Jul;19(4):311-8. doi: 10.1111/anec.12191. PMID: 25040480Free PMC Article
Clausen H, Pflaumer A, Kamberi S, Davis A
Pacing Clin Electrophysiol 2013 Mar;36(3):391-401. Epub 2012 Dec 18 doi: 10.1111/pace.12050. PMID: 23252797

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