Arrhythmias & electrophysiology

Catecholaminergic polymorphic ventricular tachycardia mediated by ryanodine receptor 2: a validated risk stratification

Eur Heart JPublished Prognostic model development and validation study

Authors' conclusion

These externally validated risk prediction models using clinical parameters accurately distinguished CPVT patients on β-blocker monotherapy at low and high risk for future AEs while treated with β-blockers.

Study context

Population
Patients with RYR2-mediated catecholaminergic polymorphic ventricular tachycardia (CPVT) on β-blocker monotherapy
Participants
743 vs 129
Comparison
Derivation vs Validation
  • Derivationn = 743
  • Validationn = 129
Outcome
Arrhythmic events (AEs) (arrhythmic syncope, appropriate ICD shock, sudden cardiac arrest, SCD)
Methodological detailsderivation and independent external validation cohorts, Cox regression
  • Derivation and independent external validation cohorts
  • Cox regression

Performance

As reported in the abstract

Model discrimination for AE (optimism-corrected C-index); predictors: arrhythmic syncope or sudden cardiac arrest (SCA) before diagnosis, age at β-blocker initiation
Test or modelValueC-index for AEMedian follow-up
Derivation13.7%0.67 (95% CI 0.62-0.72)5.1 (IQR 7.7) years
Validation18.6%0.59 (95% CI 0.48-0.71)2.4 (IQR 4.4) years

Value

Derivation13.7%
Validation18.6%

C-index for AE

Derivation0.67 (95% CI 0.62-0.72)
Validation0.59 (95% CI 0.48-0.71)

Median follow-up

Derivation5.1 (IQR 7.7) years
Validation2.4 (IQR 4.4) years

Further findings

OutcomeDerivationValidation
Near-fatal or fatal AEs (all AEs except arrhythmic syncope); fourth predictor: ventricular arrhythmia severity before β-blocker initiation
C-index0.74 (95% CI 0.68-0.80)0.60 (95% CI 0.47-0.72)
Calibration slope (derivation cohort)
1.00 (95% CI 0.59-1.41) · AE · nf/fAE 1.00 (95% CI 0.69-1.32)

Original publication

Catecholaminergic polymorphic ventricular tachycardia mediated by ryanodine receptor 2: a validated risk stratification. Eur Heart J. Published 19 December 2025. doi:10.1093/eurheartj/ehaf965

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