Syncopes and channelopathies

Herzschrittmachertherapie & Elektrophysiologie
Johanna Müller-LeisseChristian Veltmann

Abstract

Syncope can be the first manifestation of cardiac channelopathies, namely Brugada syndrome, long QT syndrome, short QT syndrome and catecholaminergic polymorphic ventricular tachycardia (CPVT). Patients affected by these rare diseases are at increased risk for sudden cardiac death due to ventricular tachyarrhythmias and require specific therapy and follow-up. As syncope is common in the general population, only few cases are caused by an underlying channelopathy. Nevertheless, the diagnosis should be considered in young patients with structurally normal hearts, especially if the history of syncope is typical for an arrhythmogenic cause, in the presence of characteristic echocardiogram (ECG) patterns, and if there is a family history of channelopathies or sudden cardiac death. On the other hand, syncope plays an important role in the management of patients with diagnosed channelopathies, as they may indicate an increased risk for sudden cardiac death. The predictive value and consequences for treatment vary between the different channelopathies. However, data on this issue are scarce due to the low prevalence of these diseases. This review highlights typical findings in the medical history and diagnostic tests that may point tow...Continue Reading

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