Cardiac Channelopathies and Sudden Death: Recent Clinical and Genetic Advances

Anna Fernández-Falgueras, Georgia Sarquella-Brugada, Josep Brugada, Ramon Brugada, Oscar Campuzano, Anna Fernández-Falgueras, Georgia Sarquella-Brugada, Josep Brugada, Ramon Brugada, Oscar Campuzano

Abstract

Sudden cardiac death poses a unique challenge to clinicians because it may be the only symptom of an inherited heart condition. Indeed, inherited heart diseases can cause sudden cardiac death in older and younger individuals. Two groups of familial diseases are responsible for sudden cardiac death: cardiomyopathies (mainly hypertrophic cardiomyopathy, dilated cardiomyopathy, and arrhythmogenic cardiomyopathy) and channelopathies (mainly long QT syndrome, Brugada syndrome, short QT syndrome, and catecholaminergic polymorphic ventricular tachycardia). This review focuses on cardiac channelopathies, which are characterized by lethal arrhythmias in the structurally normal heart, incomplete penetrance, and variable expressivity. Arrhythmias in these diseases result from pathogenic variants in genes encoding cardiac ion channels or associated proteins. Due to a lack of gross structural changes in the heart, channelopathies are often considered as potential causes of death in otherwise unexplained forensic autopsies. The asymptomatic nature of channelopathies is cause for concern in family members who may be carrying genetic risk factors, making the identification of these genetic factors of significant clinical importance.

Keywords: arrhythmias; channelopathies; genetics; sudden cardiac death.

Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Brugada syndrome type I electrocardiogram (ECG) from a 59-year-old male.
Figure 2
Figure 2
Diagram of the overlap between the genes associated with Brugada syndrome (BrS), short QT syndrome (SQTS), long short QT syndrome (LQTS) and catecholaminergic polymorphic ventricular tachycardia (CPVT).
Figure 3
Figure 3
ECG from a 20-year-old patient with LQTS.
Figure 4
Figure 4
ECG from a patient with SQTS.
Figure 5
Figure 5
Exercise ECGs from a patient with CPVT. (a) Basal; (b) Bidireccional ventricular arrhythmia.

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Source: PubMed

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