Arrhythmias & electrophysiology

Burst Exercise Stress Testing in Catecholaminergic Polymorphic Ventricular Tachycardia

JAMA CardiolPublished Retrospective cohort study

Authors' conclusion

In this cohort study, the Burst exercise stress testing protocol detected a greater burden and severity of ventricular arrhythmias than the Bruce protocol in patients with CPVT, frequently prompting treatment escalation without observed safety concerns.

Study context

Population
Pediatric and adult patients evaluated for catecholaminergic polymorphic ventricular tachycardia (CPVT) who had undergone consecutive Bruce and Burst exercise tests, Vancouver, Canada, 2017–202438 screened
Participants
28 participants
Exposure
Burst vs Bruce exercise stress testing protocol
Outcome
Ventricular Arrhythmia Score (0 = no premature ventricular contractions to 4 = nonsustained VT)
Methodological details2 tertiary referral centers
  • 2 tertiary referral centers

Main finding

As reported in the abstract

Ventricular Arrhythmia Score

Burst

3

median · IQR 2–4

Bruce

1

median · IQR 1–2

P < 0.001

Burst provoked more severe arrhythmias
20 of 28 patients (71%)

Observational data: associations, not effects.

Further findings

β-blocker or flecainide initiation or dose escalation

Therapy initiated or escalated after Burst findings
13 patients (65%)

Safety

No adverse safety events occurred

Original publication

Burst Exercise Stress Testing in Catecholaminergic Polymorphic Ventricular Tachycardia. JAMA Cardiol. Published 1 May 2026. doi:10.1001/jamacardio.2026.0384

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