Treatment of Catecholaminergic Polymorphic Ventricular Tachycardia: Lessons from One Case

Authors

  • Lampros Sioros Department of Cardiology, University of Ioannina, 1 St. Niarxou Avenue, 45500 Ioannina, Greece
  • Giannis G Baltogiannis Department of Cardiology, University of Ioannina, 1 St. Niarxou Avenue, 45500 Ioannina, Greece. Current address: Heart Rhythm Management Center, Universitair Ziekenhuis Brussel, 1090 Brussels, Belgium
  • Dimitrios N Lysitsas Department of Cardiology, University of Ioannina, 1 St. Niarxou Avenue, 45500 Ioannina, Greece. Current address: Royal Brompton and Harefield Hospitals Foundation Trust, Hill End Road, Harefield, Middlesex, UB9 6JH, UK
  • Theofilos M Kolettis Department of Cardiology, University of Ioannina, 1 St. Niarxou Avenue, 45500 Ioannina, Greece

DOI:

https://doi.org/10.2015/hc.v9i1.562

Keywords:

catecholaminergic polymorphic ventricular tachycardia, β-blockers, amiodarone, flecainide, implantable cardioverter-defibrillator

Abstract

We report a case of a 27-year-old female with catecholaminergic polymorphic ventricular tachycardia, presenting with syncope during emotional stress. β-Blockade alone was ineffective, whereas the addition of amiodarone prevented arrhythmia-relapses for 28 months. In view of planned pregnancy, the latter was substituted with flecainide, coupled with defibrillator-implantation. Fourteen months later, the patient had 3 appropriate, followed by 3 inappropriate shocks. This case highlights the short-comings of pharmacological treatment and the limitations of device-therapy; the high rate of inefficacious shocks, along with the proarrhythmic potential, point towards the judicious use of defibrillators, aiming at shock-delivery only for ventricular fibrillation.

Author Biography

Theofilos M Kolettis, Department of Cardiology, University of Ioannina, 1 St. Niarxou Avenue, 45500 Ioannina, Greece

Professor in Cardiology

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Published

2013-10-26

Issue

Section

CASE REPORTS