Ventricular arrhythmias (VAs) in patients with catecholaminergic polymorphic ventricular
tachycardia type 1 (CPVT1) are triggered at an individual and reproducible heart rate
(HR) during exercise. Long-term effects of exercise on arrhythmia threshold in CPVT1
are not known. To investigate whether exercise training (ET) is feasible in patients
with CPVT1, 13 patients with CPVT1 and confirmed genetic mutations performed bicycle
exercise testing with maximal oxygen uptake (VO2max) measurements at baseline and after 13 weeks. The threshold HR for VA was defined
as the HR when bigeminal ventricular extrasystoles or more severe VAs occurred. Six
patients were enrolled in a 12-week high-intensity ergometer bicycle ET program (ET
patients) with 60 min exercise sessions 3 times per week. The remaining 7 patients
with CPVT1 were included as “sedentary” control (SED) patients complying with current
recommendations to restrain from high-intensity physical activity. ET patients completed
28 ± 3 exercise sessions (78 ± 8% program completion) with 13 ± 3% increase in VO2max versus baseline (20.2 ± 1.6 vs 17.9 ± 1.3 ml/kg/min, p <0.05). No adverse events
occurred. Baseline threshold for VA was 100 ± 6 beats/min in ET patients and 135 ±
4 beats/min in SED patients. After the training period, threshold HR for VA was 111
± 10 beats/min in ET patients and 123 ± 6 beats/min in SED patients. The threshold
for VA increased in ET compared with SED patients (+11 vs −12 beats/min, p <0.05).
In conclusion, patients with CPVT1 benefitted from individualized ET with improved
aerobic capacity and increased threshold HR for VA compared with SED patients.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to American Journal of CardiologyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- A missense mutation in CASQ2 is associated with autosomal recessive catecholamine-induced polymorphic ventricular tachycardia in Bedouin families from Israel.Ann Med. 2004; 36: 87-91
- Catecholaminergic polymorphic ventricular tachycardia in children. A 7-year follow-up of 21 patients.Circulation. 1995; 91: 1512-1519
- Clinical and molecular characterization of patients with catecholaminergic polymorphic ventricular tachycardia.Circulation. 2002; 106: 69-74
- Arrhythmic disorder mapped to chromosome 1q42-q43 causes malignant polymorphic ventricular tachycardia in structurally normal hearts.J Am Coll Cardiol. 1999; 34: 2035-2042
- High prevalence of exercise-induced arrhythmias in catecholaminergic polymorphic ventricular tachycardia mutation-positive family members diagnosed by cascade genetic screening.Europace. 2010; 12: 417-423
- ACC/AHA/ESC 2006 guidelines for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: a report of the American College of Cardiology/American Heart Association Task Force and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Develop Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death).J Am Coll Cardiol. 2006; 48: e247-e346
- Exercise training improves cardiac function and attenuates arrhythmia in CPVT mice.J Appl Physiol. 2012; 113: 1677-1683
- Interval training normalizes cardiomyocyte function, diastolic Ca2+ control, and SR Ca2+ release synchronicity in a mouse model of diabetic cardiomyopathy.Circ Res. 2009; 105: 527-536
- Cardiac autonomic neural remodeling and susceptibility to sudden cardiac death: effect of endurance exercise training.Am J Physiol Heart Circ Physiol. 2009; 297: H1171-H1193
- Calmodulin kinase II inhibition prevents arrhythmias in RyR2(R4496C+/-) mice with catecholaminergic polymorphic ventricular tachycardia.J Mol Cell Cardiol. 2011; 50: 214-222
- Calcium/calmodulin-dependent protein kinase II contributes to cardiac arrhythmogenesis in heart failure.Circ Heart Fail. 2009; 2: 664-675
- Superior cardiovascular effect of aerobic interval training versus moderate continuous training in heart failure patients: a randomized study.Circulation. 2007; 115: 3086-3094
- Competitive sports participation in athletes with congenital long QT syndrome.JAMA. 2012; 308: 764-765
- Return to play? Athletes with congenital long QT syndrome.Br J Sports Med. 2013; 47: 28-33
- The safety of cardiopulmonary exercise testing in a population with high-risk cardiovascular diseases.Circulation. 2012; 126: 2465-2472
- Activity patterns of men attending for fitness assessment.Br J Sports Med. 1988; 22: 101-106
- Effects of age on ventilatory threshold and peak oxygen uptake normalised for regional skeletal muscle mass in Japanese men and women aged 20-80 years.Eur J Appl Physiol. 2007; 99: 475-483
- The effect of acute vs chronic treatment with beta-adrenoceptor blockade on exercise performance, haemodynamic and metabolic parameters in healthy men and women.Br J Clin Pharmacol. 1996; 41: 57-67
Article Info
Publication History
Published online: March 19, 2014
Accepted:
March 5,
2014
Received in revised form:
March 5,
2014
Received:
December 11,
2013
Footnotes
See page 1833 for disclosure information.
Identification
Copyright
© 2014 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
