Catecholaminergic polymorphic ventricular tachycardia (CPVT) | Diagnosis

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Contact the Inherited Cardiac Arrhythmia Program

Catecholaminergic polymorphic ventricular tachycardia (CPVT) is caused by a change in the genetic code for a particular cardiac protein called the ryanodine receptor. These genetic variants (also called mutations) lead to a change in the structure and function of the protein, causing it to leak calcium. This in turn triggers the ventricular ectopy and arrhythmias, and can be identified by detailed analysis of the ryanodine receptor gene, RyR2. 

Genetic testing in CPVT has become an important part of the overall diagnostic work up. This requires expert interpretation, often within the context of a whole-family evaluation. 

How is CPVT diagnosed? 

Because CPVT is only observable during periods of adrenaline, standard electrocardiograms and echocardiograms are not good diagnostic tests. Instead, if CPVT is suspected, your child will have an exercise stress test (EST). This test utilizes a treadmill or bicycle and records the heart’s function during exercise. (Younger patients too small for the treadmill use a Holter monitor). 

EST technology reveals a pattern of extra beats from the ventricles (ventricular ectopy), which become increasingly frequent and more complex as the adrenaline release increases. These extra beats often develop into complex arrhythmias called “bidirectional” or “polymorphic ventricular tachycardia”. 

Any child or young adult presenting with symptoms of CPVT during periods of exertion or strong emotion should be evaluated by a specialty team with experience diagnosing the condition.

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