@article{ref1,
title="Spectrum and frequency of cardiac channel defects in swimming-triggered arrhythmia syndromes",
journal="Circulation",
year="2004",
author="Choi, Grace and Kopplin, Laura J. and Tester, David J. and Will, Melissa L. and Haglund, Carla M. and Ackerman, Michael J.",
volume="110",
number="15",
pages="2119-2124",
abstract="BACKGROUND: Swimming is a relatively genotype-specific arrhythmogenic trigger for type 1 long-QT syndrome (LQT1). We hypothesize that mimickers of concealed LQT1, namely catecholaminergic polymorphic ventricular tachycardia (CPVT), may also underlie swimming-triggered cardiac events. METHODS AND RESULTS: Between August 1997 and May 2003, 388 consecutive, unrelated patients were referred specifically for LQTS genetic testing. The presence of a personal and/or family history of a near-drowning or drowning was determined by review of the medical records and/or phone interviews and was blinded to genetic test results. Comprehensive mutational analysis of the 5 LQTS-causing channel genes, KCNQ1 (LQT1), KCNH2 (LQT2), SCN5A (LQT3), KCNE1 (LQT5), and KCNE2 (LQT6), along with KCNJ2 (Andersen-Tawil syndrome) and targeted analysis of 18 CPVT1-associated exons in RyR2, was performed with the use of denaturing high-performance liquid chromatography and direct DNA sequencing. Approximately 11% (43 of 388) of the index cases had a positive swimming phenotype. Thirty-three of these 43 index cases had a &quot;Schwartz&quot; score (> or =4) suggesting high clinical probability of LQTS. Among this subset, 28 patients (85%) were LQT1, 2 patients (6%) were LQT2, and 3 were genotype negative. Among the 10 cases with low clinical probability for LQTS, 9 had novel, putative CPVT1-causing RyR2 mutations. CONCLUSIONS: In contrast to previous studies that suggested universal LQT1 specificity, genetic heterogeneity underlies channelopathies that are suspected chiefly because of a near-drowning or drowning. CPVT1 and strategic genotyping of RyR2 should be considered when LQT1 is excluded in the pathogenesis of a swimming-triggered arrhythmia syndrome.<p /><p>Language: en</p>",
language="en",
issn="0009-7322",
doi="10.1161/01.CIR.0000144471.98080.CA",
url="http://dx.doi.org/10.1161/01.CIR.0000144471.98080.CA"
}