Arrhythmias & electrophysiology
The Diagnostic Utility of Holter Monitoring in Catecholaminergic Polymorphic Ventricular Tachycardia
Authors' conclusion
Holter monitor PVC counts alone are inadequate for CPVT diagnosis, owing to the adrenergic nature of the disease. Quantifying PVC prevalence at a heart rate threshold >76% identified CPVT with moderate sensitivity (69%) and high specificity (94%).
Study context
- Population
- Off-therapy Holter monitoring, Canadian Hearts in Rhythm Organization national registry
- Participants
- 13 vs 34
- Exposure
- RyR2-positive catecholaminergic polymorphic ventricular tachycardia (CPVT) vs healthy controls
- CPVTn = 13
- Healthy controlsn = 34reference
- Outcome
- PVC count at >76% maximum heart rate (adrenergic stress) for CPVT diagnosis
Methodological detailsnational registry
- National registry
Main finding
As reported in the abstract
| Group | AUC | Sensitivity | Specificity |
|---|---|---|---|
| CPVT | 0.84 | 69% | 94% |
CPVT
AUC0.84
Sensitivity69%
Specificity94%
- CPVT vs Healthy controls: P = 0.002 — higher PVC count in CPVT, limited to adrenergic stress (>76% max HR)
- Optimal threshold separating adrenergic and nonadrenergic premature ventricular contractions (PVCs) in CPVT: % of maximum HR
- 76%
Observational data: associations, not effects.
Further findings
| Outcome | P value |
|---|---|
| PVC burdenDiffered between groups but within population norm | P = 0.001 |
| Overall PVC countHigher in CPVT | P = 0.002 |
| PVC count below 76% maximum HR thresholdNo significant difference | P = 0.604 |
Original publication
The Diagnostic Utility of Holter Monitoring in Catecholaminergic Polymorphic Ventricular Tachycardia. JACC Clin Electrophysiol. Published 28 August 2024. doi:10.
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