Effects of individualized exercise training in patients with catecholaminergic polymorphic ventricular tachycardia type 1.
Ventricular arrhythmias (VAs) in patients with catecholaminergic polymorphic ventricular tachycardia type 1 (CPVT1) are triggered at an individual and reproducible heart rate (HR) during exercise. Long-term effects of exercise on arrhythmia threshold in CPVT1 are not known. To investigate whether exercise training (ET) is feasible in patients with CPVT1, 13 patients with CPVT1 and confirmed genetic mutations performed bicycle exercise testing with maximal oxygen uptake (VO2max) measurements at baseline and after 13 weeks. The threshold HR for VA was defined as the HR when bigeminal ventricular extrasystoles or more severe VAs occurred. Six patients were enrolled in a 12-week high-intensity ergometer bicycle ET program (ET patients) with 60 min exercise sessions 3 times per week. The remaining 7 patients with CPVT1 were included as "sedentary" control (SED) patients complying with current recommendations to restrain from high-intensity physical activity. ET patients completed 28 ± 3 exercise sessions (78 ± 8% program completion) with 13 ± 3% increase in VO2max versus baseline (20.2 ± 1.6 vs 17.9 ± 1.3 ml/kg/min, p <0.05). No adverse events occurred. Baseline threshold for VA was 100 ± 6 beats/min in ET patients and 135 ± 4 beats/min in SED patients. After the training period, threshold HR for VA was 111 ± 10 beats/min in ET patients and 123 ± 6 beats/min in SED patients. The threshold for VA increased in ET compared with SED patients (+11 vs -12 beats/min, p <0.05). In conclusion, patients with CPVT1 benefitted from individualized ET with improved aerobic capacity and increased threshold HR for VA compared with SED patients.
Institute for Experimental Medical Research, Oslo University Hospital and University of Oslo, Oslo, Norway; KG Jebsen Cardiac Research Center and Center for Heart Failure Research, University of Oslo, Oslo, Norway. Electronic address: ravinea.manotheepan@medisin.uio.no.
Ravinea
R
Manotheepan
Department of Cardiology and Center for Cardiological Innovation, Oslo University Hospital, Rikshospitalet, Oslo, Norway; Institute for Surgical Research, Oslo University Hospital, Rikshospitalet, University of Oslo, Oslo, Norway.
Jørg
J
Saberniak
Institute for Experimental Medical Research, Oslo University Hospital and University of Oslo, Oslo, Norway; KG Jebsen Cardiac Research Center and Center for Heart Failure Research, University of Oslo, Oslo, Norway.
Tore K
TK
Danielsen
Department of Cardiology and Center for Cardiological Innovation, Oslo University Hospital, Rikshospitalet, Oslo, Norway; Institute for Surgical Research, Oslo University Hospital, Rikshospitalet, University of Oslo, Oslo, Norway.
Thor
T
Edvardsen
Institute for Experimental Medical Research, Oslo University Hospital and University of Oslo, Oslo, Norway; KG Jebsen Cardiac Research Center and Center for Heart Failure Research, University of Oslo, Oslo, Norway.
Ivar
I
Sjaastad
Department of Cardiology and Center for Cardiological Innovation, Oslo University Hospital, Rikshospitalet, Oslo, Norway; Institute for Surgical Research, Oslo University Hospital, Rikshospitalet, University of Oslo, Oslo, Norway.
Kristina H
KH
Haugaa
Institute for Experimental Medical Research, Oslo University Hospital and University of Oslo, Oslo, Norway; KG Jebsen Cardiac Research Center and Center for Heart Failure Research, University of Oslo, Oslo, Norway; Clinic for Internal Medicine, Lovisenberg Diakonale Hospital, Oslo, Norway.
Mathis K
MK
Stokke
D000293:Adolescent; D000328:Adult; D004247:DNA / Q000235:genetics; D004252:DNA Mutational Analysis; D015716:Electrocardiography, Ambulatory; D005080:Exercise Test; D005081:Exercise Therapy / Q000379:methods*; D017079:Exercise Tolerance / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D020022:Genetic Predisposition to Disease; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D009154:Mutation; D019837:Ryanodine Receptor Calcium Release Channel / Q000235:genetics / Q000378:metabolism; D017180:Tachycardia, Ventricular / Q000235:genetics / Q000503:physiopathology / Q000628:therapy*; D055815:Young Adult; D000098850:Polymorphic Catecholaminergic Ventricular Tachycardia
D019837:Ryanodine Receptor Calcium Release Channel; D004247:DNA