Korean Circ J.  2012 Feb;42(2):129-132. 10.4070/kcj.2012.42.2.129.

Catecholaminergic Polymorphic Ventricular Tachycardia in a Patient With Recurrent Exertional Syncope

• Kim NY
• Kang JK
• Park SH
• Bae MH
• Lee JH
• Yang DH
• Park HS
• Chae SC
• Jun JE
• Cho Y

• KMID: 1826387
• DOI: http://doi.org/10.4070/kcj.2012.42.2.129

Abstract

A 16-year-old male with a prior history of recurrent syncope was referred to our hospital after being resuscitated from cardiac arrest developed while playing volleyball. His electrocardiogram (ECG) demonstrated ventricular fibrillation at a local emergency department. After referral, an ECG showed bidirectional ventricular tachycardia (VT) and nonsustained Torsade de Pointes. Two days later, his heart rate became regular, and no additional episodes of VT were observed. His ECG showed sinus rhythm with a corrected QT interval of 423 msec, and two-dimensional echocardiography was unremarkable. We made the diagnosis of a catecholaminergic polymorphic VT. However, only premature ventricular complex bigeminy was induced on exercise ECG and epinephrine infusion tests, and the patient showed no episodes of syncope. His father and mother had different missense mutations in the cardiac ryanodine receptor on genetic testing. The proband had both mutations in different alleles and was symptomatic. It was recommended that the patient avoid competitive physical activities, and a beta-blocker was prescribed.

Keyword

Catecholamines; Tachycardia, ventricular; Genetics; Syncope; Exercise

MeSH Terms

Adolescent
Alleles
Catecholamines
Echocardiography
Electrocardiography
Emergencies
Epinephrine
Fathers
Genetic Testing
Heart Arrest
Heart Rate
Humans
Male
Mothers
Motor Activity
Mutation, Missense
Referral and Consultation
Ryanodine Receptor Calcium Release Channel
Syncope
Tachycardia
Tachycardia, Ventricular
Torsades de Pointes
Ventricular Fibrillation
Ventricular Premature Complexes
Volleyball
Catecholamines
Epinephrine
Ryanodine Receptor Calcium Release Channel
Tachycardia
Tachycardia, Ventricular

Figure

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  Fig. 1 Twelve-lead electrocardiogram in the coronary care unit shows bidirectional ventricular tachycardia.

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  Fig. 2 Baseline electrocardiogram shows a normal sinus rhythm with a normal QT interval.

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  Fig. 3 Ventricular bigeminy was seen at the peak heart rate during exercise electrocardiogram testing after the patient was administered propranolol.

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