Catecholaminergic Polymorphic Ventricular Tachycardia: A Review of Therapeutic Strategies

Card Electrophysiol Clin. 2023 Sep;15(3):293-305. doi: 10.1016/j.ccep.2023.04.002. Epub 2023 Jun 20.

Abstract

Catecholaminergic polymorphic ventricular tachycardia (CPVT) is an inherited arrhythmia syndrome characterized by bidirectional or polymorphic ventricular arrhythmia provoked by exercise or emotion. Most cases are caused by pathogenic variants in the gene encoding the cardiac ryanodine receptor (RYR2). The options for treating patients with CPVT have increased during the years, and evidence suggests that these have led to lower arrhythmic event rates. In addition, numerous potential new therapies are being investigated. In this review, we summarize the state of knowledge on both established and potential future treatment strategies for patients with CPVT and describe our approach to their management.

Keywords: Catecholaminergic polymorphic ventricular tachycardia; Flecainide; RYR2-specific compounds; Sudden cardiac death; Therapeutic management; β-blockers.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anti-Arrhythmia Agents*
  • Death, Sudden, Cardiac / etiology
  • Exercise
  • Humans
  • Mutation
  • Polymorphic Catecholaminergic Ventricular Tachycardia
  • Ryanodine Receptor Calcium Release Channel / genetics
  • Tachycardia, Ventricular* / genetics
  • Tachycardia, Ventricular* / therapy

Substances

  • Anti-Arrhythmia Agents
  • Ryanodine Receptor Calcium Release Channel