Treatment of Catecholaminergic Polymorphic Ventricular Tachycardia with History of Aborted Cardiac Arrest
Clinical Scenario
High-Risk Presentation
This protocol addresses patients with catecholaminergic polymorphic ventricular tachycardia (CPVT) who have experienced an aborted cardiac arrest. Survival of a cardiac arrest in the context of CPVT identifies a subset requiring maximal protective management.
Treatment Approach
Management combines lifestyle restriction — including avoidance of competitive sports, strenuous exertion, and stressful environments — with pharmacological therapy and device-based intervention. Non-selective beta-blockers form the pharmacological backbone, alongside an additional antiarrhythmic agent for this high-risk group.
The complete regimen — including specific agents, their combination, and full device criteria — is available in the structured protocol below.
References
DOI: 10.1093/eurheartj/ehac262
- Avoidance of competitive sports, strenuous exercise, and exposure to stressful environments is recommended in all patients with CPVT.
- Beta-blockers, ideally non-selective (nadolol or propranolol) are recommended in all patients with a clinical diagnosis of CPVT.
- ICD implantation combined with beta-blockers and flecainide is recommended in CPVT patients after aborted CA.
- Maximal protection with beta-blockers, flecainide and ICD is indicated in survivors of a CA.
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