Marwan M Refaat1, Mostafa Hotait, Zian H Tseng. 1. Section of Cardiac Electrophysiology, Division of Cardiology, Department of Medicine, American University of Beirut Faculty of Medicine and Medical Center, Beirut, Lebanon.
Abstract
BACKGROUND: Sudden cardiac death (SCD) remains a major public health problem. Current established criteria identifying those at risk of sudden arrhythmic death, and likely to benefit from implantable cardioverter defibrillators (ICDs), are neither sensitive nor specific. Exercise electrocardiogram (ECG) testing was traditionally used for information concerning patients' symptoms, exercise capacity, cardiovascular function, myocardial ischemia detection, and hemodynamic responses during activity in patients with hypertrophic cardiomyopathy. METHODS: We conducted a systematic review of MEDLINE on the utility of exercise ECG testing in SCD risk stratification. RESULTS: Exercise testing can unmask suspected primary electrical diseases in certain patients (catecholaminergic polymorphic ventricular tachycardia or concealed long QT syndrome) and can be effectively utilized to risk stratify patients at an increased (such as early repolarization syndrome and Brugada syndrome) or decreased risk of SCD, such as the loss of preexcitation on exercise testing in asymptomatic Wolff-Parkinson-White syndrome. CONCLUSIONS: Exercise ECG testing helps in SCD risk stratification in patients with and without arrhythmogenic hereditary syndromes.
BACKGROUND:Sudden cardiac death (SCD) remains a major public health problem. Current established criteria identifying those at risk of sudden arrhythmic death, and likely to benefit from implantable cardioverter defibrillators (ICDs), are neither sensitive nor specific. Exercise electrocardiogram (ECG) testing was traditionally used for information concerning patients' symptoms, exercise capacity, cardiovascular function, myocardial ischemia detection, and hemodynamic responses during activity in patients with hypertrophic cardiomyopathy. METHODS: We conducted a systematic review of MEDLINE on the utility of exercise ECG testing in SCD risk stratification. RESULTS: Exercise testing can unmask suspected primary electrical diseases in certain patients (catecholaminergic polymorphic ventricular tachycardia or concealed long QT syndrome) and can be effectively utilized to risk stratify patients at an increased (such as early repolarization syndrome and Brugada syndrome) or decreased risk of SCD, such as the loss of preexcitation on exercise testing in asymptomatic Wolff-Parkinson-White syndrome. CONCLUSIONS: Exercise ECG testing helps in SCD risk stratification in patients with and without arrhythmogenic hereditary syndromes.
Authors: Gregory Engel; James G Beckerman; Victor F Froelicher; Takuya Yamazaki; Henry A Chen; Kelly Richardson; Ryan J McAuley; Euan A Ashley; Sung Chun; Paul J Wang Journal: Curr Probl Cardiol Date: 2004-07 Impact factor: 5.200
Authors: Douglas P Zipes; A John Camm; Martin Borggrefe; Alfred E Buxton; Bernard Chaitman; Martin Fromer; Gabriel Gregoratos; George Klein; Arthur J Moss; Robert J Myerburg; Silvia G Priori; Miguel A Quinones; Dan M Roden; Michael J Silka; Cynthia Tracy; Sidney C Smith; Alice K Jacobs; Cynthia D Adams; Elliott M Antman; Jeffrey L Anderson; Sharon A Hunt; Jonathan L Halperin; Rick Nishimura; Joseph P Ornato; Richard L Page; Barbara Riegel; Silvia G Priori; Jean-Jacques Blanc; Andrzej Budaj; A John Camm; Veronica Dean; Jaap W Deckers; Catherine Despres; Kenneth Dickstein; John Lekakis; Keith McGregor; Marco Metra; Joao Morais; Ady Osterspey; Juan Luis Tamargo; José Luis Zamorano Journal: J Am Coll Cardiol Date: 2006-09-05 Impact factor: 24.094
Authors: Mitchell I Cohen; John K Triedman; Bryan C Cannon; Andrew M Davis; Fabrizio Drago; Jan Janousek; George J Klein; Ian H Law; Fred J Morady; Thomas Paul; James C Perry; Shubhayan Sanatani; Ronn E Tanel Journal: Heart Rhythm Date: 2012-05-10 Impact factor: 6.343
Authors: Silvia G Priori; Arthur A Wilde; Minoru Horie; Yongkeun Cho; Elijah R Behr; Charles Berul; Nico Blom; Josep Brugada; Chern-En Chiang; Heikki Huikuri; Prince Kannankeril; Andrew Krahn; Antoine Leenhardt; Arthur Moss; Peter J Schwartz; Wataru Shimizu; Gordon Tomaselli; Cynthia Tracy; Michael Ackerman; Bernard Belhassen; N A Mark Estes; Diane Fatkin; Jonathan Kalman; Elizabeth Kaufman; Paulus Kirchhof; Eric Schulze-Bahr; Christian Wolpert; Jitendra Vohra; Marwan Refaat; Susan P Etheridge; Robert M Campbell; Edward T Martin; Swee Chye Quek Journal: Europace Date: 2013-08-30 Impact factor: 5.214
Authors: Daniel A Steinhaus; Eric Vittinghoff; Ellen Moffatt; Amy P Hart; Philip Ursell; Zian H Tseng Journal: Am Heart J Date: 2012-01 Impact factor: 4.749
Authors: Michel Haïssaguerre; Nicolas Derval; Frederic Sacher; Laurence Jesel; Isabel Deisenhofer; Luc de Roy; Jean-Luc Pasquié; Akihiko Nogami; Dominique Babuty; Sinikka Yli-Mayry; Christian De Chillou; Patrice Scanu; Philippe Mabo; Seiichiro Matsuo; Vincent Probst; Solena Le Scouarnec; Pascal Defaye; Juerg Schlaepfer; Thomas Rostock; Dominique Lacroix; Dominique Lamaison; Thomas Lavergne; Yoshifusa Aizawa; Anders Englund; Frederic Anselme; Mark O'Neill; Meleze Hocini; Kang Teng Lim; Sebastien Knecht; George D Veenhuyzen; Pierre Bordachar; Michel Chauvin; Pierre Jais; Gaelle Coureau; Genevieve Chene; George J Klein; Jacques Clémenty Journal: N Engl J Med Date: 2008-05-08 Impact factor: 91.245
Authors: Marek Jastrzębski; Piotr Kukla; Maciej Pitak; Andrzej Rudziński; Adrian Baranchuk; Danuta Czarnecka Journal: Ann Noninvasive Electrocardiol Date: 2017-05-12 Impact factor: 1.468
Authors: Felix Bourier; Arnaud Denis; Ghassen Cheniti; Anna Lam; Konstantinos Vlachos; Masateru Takigawa; Takeshi Kitamura; Antonio Frontera; Josselin Duchateau; Thomas Pambrun; Nicolas Klotz; Nicolas Derval; Frédéric Sacher; Pierre Jais; Michel Haissaguerre; Mélèze Hocini Journal: Front Cardiovasc Med Date: 2018-11-27