Predictors of β-blocker adherence in cardiac inherited disease

O’Donovan, Claire; Waddell-Smith, K.; Skinner, Jonathan R.; Broadbent, Elizabeth

doi:10.1136/openhrt-2018-000877

Cited by 12 publications

(16 citation statements)

References 30 publications

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“…Medications are recommended for many patients with inherited cardiovascular diseases, especially for those with arrhythmia syndromes. For young patients, adherence to β-blocker medication can be strongly influenced by psychological and social factors (Ingles et al 2015;O'Donovan et al 2018). In the setting of LQTS, β-blocker therapy is shown to reduce the likelihood of cardiac arrhythmias and is an important first-tier treatment (Chockalingam et al 2012).…”

Section: Research Findingsmentioning

confidence: 99%

“…In the medical literature, studies of adherence to any prescribed therapy indicate that psychological factors, including illness perception, beliefs about the medication, self-efficacy (i.e., their confidence in their ability to take the medication), and psychosocial well-being, are important determinants of medication adherence (Jin et al 2008). One study examining adherence to β-blocker therapy among patients with LQTS found 16% were not adherent (O'Donovan et al 2018). Those who were younger and had an inherited arrhythmia syndrome reported lower self-efficacy, greater concerns, low necessity beliefs, and poorer understanding of their disease.…”

Section: Research Findingsmentioning

confidence: 99%

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Psychological Issues in Managing Families with Inherited Cardiovascular Diseases

Ingles

2019

Cold Spring Harb Perspect Med

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Section: Research Findingsmentioning

confidence: 99%

Section: Research Findingsmentioning

confidence: 99%

Psychological Issues in Managing Families with Inherited Cardiovascular Diseases

Ingles

2019

Cold Spring Harb Perspect Med

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“…Alternatively, this might be due to fluctuations in the drug serum levels and its corresponding antiarrhythmic effect on the EST. Non-adherence—a well-known problem in the treatment of inherited cardiac arrhythmias 23 —prior to the EST might underlie these fluctuations. This is in line with our observation that the difference in maximum heart rate between ESTs was associated with the odds for an increased ΔVAS and the repeatability of the maximum heart rate in the EST-pairs with a ΔVAS > 1 was substantial but almost perfect in the pairs with a ΔVAS of 0 and 1.…”

Section: Discussionmentioning

confidence: 99%

Repeatability of ventricular arrhythmia characteristics on the exercise-stress test in RYR2-mediated catecholaminergic polymorphic ventricular tachycardia

et al. 2022

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Aims In catecholaminergic polymorphic ventricular tachycardia (CPVT), the exercise-stress test (EST) is the cornerstone for the diagnosis, risk stratification, and assessment of therapeutic efficacy, but its repeatability is unknown. We aimed to test the repeatability of ventricular arrhythmia characteristics on the EST in patients with CPVT. Methods and results EST-pairs (ESTs performed within 18 months between 2005 and 2021, on the same protocol, and without or on the exact same treatment) of patients with RYR2-mediated CPVT from two specialized centres were included. The primary endpoint was the repeatability of the maximum ventricular arrhythmia score [VAS: 0 for the absence of premature ventricular contractions (PVCs); 1 for isolated PVCs; 2 for bigeminal PVCs; 3 for couplets; and 4 for non-sustained ventricular tachycardia]. Secondary outcomes were the repeatability of the heart rate at the first PVC and the ΔVAS (the absolute difference in VAS between the EST-pairs). A total of 104 patients with 349 EST-pairs were included. The median duration between ESTs was 343 (interquartile range, 189–378) days. Sixty (17.2%) EST-pairs were off therapy. The repeatability of the VAS was moderate {Krippendorf α, 0.56 [95% confidence interval (CI), 0.48–0.64]}, and the repeatability of the heart rate at the first PVC was substantial [intra-class correlation coefficient, 0.78 (95% CI, 0.71–0.84)]. The use of medication was associated with a higher odds for a ΔVAS > 1 (odds ratio = 3.52; 95% CI, 2.46–4.57; P = 0.020). Conclusion The repeatability of ventricular arrhythmia characteristics was moderate to substantial. This underlines the need for multiple ESTs in CPVT patients and CPVT suspicious patients and it provides the framework for assessing the therapeutic efficacy of novel CPVT therapies.

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“…In a study from New Zealand, adequate adherence was reported in only 50% of LQT patients 44. Side effects are frequent and contribute, with illness perception and believe in medication, to non-adherence 44 45. Obviously, this has potentially serious impact on the freedom from arrhythmic events.…”

Section: Introductionmentioning

confidence: 99%

Diagnosis, management and therapeutic strategies for congenital long QT syndrome

Wilde

Amin

Postema

2021

Heart

123

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Congenital long QT syndrome (LQTS) is characterised by heart rate corrected QT interval prolongation and life-threatening arrhythmias, leading to syncope and sudden death. Variations in genes encoding for cardiac ion channels, accessory ion channel subunits or proteins modulating the function of the ion channel have been identified as disease-causing mutations in up to 75% of all LQTS cases. Based on the underlying genetic defect, LQTS has been subdivided into different subtypes. Growing insights into the genetic background and pathophysiology of LQTS has led to the identification of genotype–phenotype relationships for the most common genetic subtypes, the recognition of genetic and non-genetic modifiers of phenotype, optimisation of risk stratification algorithms and the discovery of gene-specific therapies in LQTS. Nevertheless, despite these great advancements in the LQTS field, large gaps in knowledge still exist. For example, up to 25% of LQTS cases still remain genotype elusive, which hampers proper identification of family members at risk, and it is still largely unknown what determines the large variability in disease severity, where even within one family an identical mutation causes malignant arrhythmias in some carriers, while in other carriers, the disease is clinically silent. In this review, we summarise the current evidence available on the diagnosis, clinical management and therapeutic strategies in LQTS. We also discuss new scientific developments and areas of research, which are expected to increase our understanding of the complex genetic architecture in genotype-negative patients, lead to improved risk stratification in asymptomatic mutation carriers and more targeted (gene-specific and even mutation-specific) therapies.

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Predictors of β-blocker adherence in cardiac inherited disease

Cited by 12 publications

References 30 publications

Psychological Issues in Managing Families with Inherited Cardiovascular Diseases

Psychological Issues in Managing Families with Inherited Cardiovascular Diseases

Repeatability of ventricular arrhythmia characteristics on the exercise-stress test in RYR2-mediated catecholaminergic polymorphic ventricular tachycardia

Diagnosis, management and therapeutic strategies for congenital long QT syndrome

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