Implantable defibrillators versus medical therapy for cardiac channelopathies

Beta-blocker therapy for long QT syndrome and catecholaminergic polymorphic ventricular tachycardia: Are all beta-blockers equivalent?

“…The lack of RCTs for both LQTS and CPVT has been documented recently by a Cochrane Review aimed at defining the role of medical therapy vs implantable cardioverter-defibrillator (ICD) therapy in channelopathies. 6 The authors concluded that such a review was not possible secondary to the lack of RCTs that would fit the methodology of Cochrane Reviews in LQTS and CPVT. 6 As a consequence, the evidence that beta-blockers are effective in reducing cardiac events in patients with either LQTS or CPVT is drawn from single expert center experiences or multicenter registries that are collected in different parts of the world with heterogeneous methodologies.…”

“…6 The authors concluded that such a review was not possible secondary to the lack of RCTs that would fit the methodology of Cochrane Reviews in LQTS and CPVT. 6 As a consequence, the evidence that beta-blockers are effective in reducing cardiac events in patients with either LQTS or CPVT is drawn from single expert center experiences or multicenter registries that are collected in different parts of the world with heterogeneous methodologies. This evidence is complicated by methodologic limitations inherent to data derived from registries.…”

2022 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death

“…ICD implantation is therefore indicated in symptomatic BrS patients who are survivors of CA or have documented spontaneous sustained VA (Figure 33). 980,[990][991][992][993][994] Approximately one-third of BrS patients present with syncope. 995 The risk of arrhythmic events in BrS patients with unexplained syncope is 4 times higher than the risk in asymptomatic patients.…”

“…995 The risk of arrhythmic events in BrS patients with unexplained syncope is 4 times higher than the risk in asymptomatic patients. 155,[990][991][992]994,996 Detailed patient history, including absence of prodrome or specific triggers, is essential for distinguishing arrhythmic from non-arrhythmic syncope. Nonetheless, the aetiology of syncope is difficult to determine in up to 30% of BrS patients.…”

“…Treatment of fever with antipyretic drugs.I CRisk stratification, prevention of SCD and treatment of VA ICD implantation is recommended in patients with BrS who:(a) Are survivors of an aborted CA and/or (b) Have documented spontaneous sustained VT 980,[990][991][992]. …”