Abstract | BACKGROUND: METHODS: In this retrospective observational study, we included patients ≤65 years of age with an EST without antiarrhythmic drugs who attained at least 80% of their age- and sex-predicted maximal HR. HRR in the recovery phase was calculated as the difference in heart rate (HR) at maximal exercise and at 1 minute in the recovery phase (ΔHRR1'). RESULTS: We included 187 patients (median age, 36 years; 68 [36%] symptomatic before diagnosis). Pre-EST HR and maximal HR were equal among symptomatic and asymptomatic patients. Patients who were symptomatic before diagnosis had a greater ΔHRR1' after maximal exercise (43 [interquartile range, 25-58] versus 25 [interquartile range, 19-34] beats/min; P<0.001). Corrected for age, sex, and relatedness, patients in the upper tertile for ΔHRR1' had an odds ratio of 3.4 (95% CI, 1.6-7.4) of being symptomatic before diagnosis (P<0.001). In addition, ΔHRR1' was higher in patients with complex ventricular arrhythmias at EST off antiarrhythmic drugs (33 [interquartile range, 22-48] versus 27 [interquartile range, 20-36] beats/min; P=0.01). After diagnosis, patients with a ΔHRR1' in the upper tertile of its distribution had significantly more arrhythmic events as compared with patients in the other tertiles (P=0.045). CONCLUSIONS:
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Authors | Krystien V V Lieve, Veronica Dusi, Christian van der Werf, J Martijn Bos, Conor M Lane, Mathis Korseberg Stokke, Thomas M Roston, Aurora Djupsjöbacka, Yuko Wada, Isabelle Denjoy, Henning Bundgaard, Ferran Roses I Noguer, Christopher Semsarian, Tomas Robyns, Nynke Hofman, Michael W Tanck, Maarten P van den Berg, Janneke A E Kammeraad, Andrew D Krahn, Sally-Ann B Clur, Frederic Sacher, Jan Till, Jonathan R Skinner, Jacob Tfelt-Hansen, Vincent Probst, Antoine Leenhardt, Minoru Horie, Heikki Swan, Jason D Roberts, Shubhayan Sanatani, Kristina H Haugaa, Peter J Schwartz, Michael J Ackerman, Arthur A M Wilde |
Journal | Circulation. Arrhythmia and electrophysiology
(Circ Arrhythm Electrophysiol)
Vol. 13
Issue 3
Pg. e007471
(03 2020)
ISSN: 1941-3084 [Electronic] United States |
PMID | 32063070
(Publication Type: Journal Article, Multicenter Study, Observational Study, Research Support, Non-U.S. Gov't)
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Topics |
- Adult
- Electrocardiography
- Exercise
(physiology)
- Exercise Test
- Female
- Follow-Up Studies
- Heart Rate
(physiology)
- Humans
- Male
- Middle Aged
- Recovery of Function
(physiology)
- Retrospective Studies
- Tachycardia, Ventricular
(diagnosis, physiopathology)
- Vagus Nerve
(physiopathology)
- Young Adult
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