Exercise‐Induced Atrial and Ventricular Tachycardias in a Patient with Left Ventricular Noncompaction and Normal Ejection Fraction

Abstract

We report a patient with ventricular and atrial tachycardias reproducibly induced during exercise testing. Atrial tachycardia, but no sustained ventricular tachycardia, was induced during electrophysiological study. Catecholaminergic polymorphic ventricular tachycardia was considered because of normal echocardiogram, family history of sudden death, and polymorphic appearance of some of the nonsustained ventricular tachycardia episodes. However, most episodes of ventricular tachycardia were monomorphic. Cardiac magnetic resonance diagnosed isolated left ventricular noncompaction.

Sports participation in non-compaction cardiomyopathy: a systematic review

“…A family history of sudden cardiac death (SCD) was present in 8 of 18 cases (44%) 19–21 27 30 33 34. One,20 had a brother who died suddenly at the age of 17 while cycling and a sister who died suddenly at the age of 21 while running.…”

“…Sustained ventricular tachycardia (VT) was observed in four cases 20 22 29 30. Premature ventricular complexes (PVCs) were also seen in one of these four cases 20.…”

“…Two additional cases27 34 had PVCs. Left ventricular hypertrophy was the most consistent ECG finding 20 25 30 32 34. A 14-year-old boy presented with syncope while running had an ECG evidence of accelerated atrioventricular conduction (Wolff-Parkinson-White syndrome) 23…”

“…Both of these patients,21 22 after informed discussion, continued light, low-impact activity which included golf. ICD implantation was recommended in seven patients,25 34 20–23 although one refused 30. Anticoagulation with warfarin was initiated in two cases with identified thrombus34 or a history suggestive of thrombus 33.…”

“…Five patients20 28–30 33 in our series underwent exercise testing. PVCs and sustained VTs were seen in two patients29 30 and one case20 had PVCs. It is prudent that all athletes or active individuals with NCCM should undergo exercise testing that mimics as closely as possible the cardiovascular demands of their sport activity.…”