{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T00:29:03Z","timestamp":1786408143225,"version":"build-2736575974"},"reference-count":27,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T00:00:00Z","timestamp":1782777600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T00:00:00Z","timestamp":1782777600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cardiovasc electrophysiol"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Catecholaminergic polymorphic ventricular tachycardia (CPVT) is a potentially life\u2010threatening arrhythmic disorder typically treated with beta\u2010blockers and, occasionally, with flecainide.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>All patients underwent genetic testing, electrocardiogram, echocardiogram, and exercise testing. Ventricular arrhythmias were assessed using qualitative and quantitative scoring systems. Flecainide dosing was progressively titrated, and follow\u2010up extended from 2007 to 2024.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 235 genetically confirmed carriers of the RyR2 (ryanodine receptor 2) p.Gly357Ser mutation, 32 required combination therapy with beta\u2010blockers and flecainide (age at diagnosis 18 [1\u201355] years; age at flecainide initiation 32 [15\u201366] years; 50% male). Forty\u2010seven percent had an implantable cardioverter defibrillator (ICD). Flecainide was indicated for exercise\u2010induced ventricular arrhythmias despite beta\u2010blocker therapy, and the median treatment duration was 7.3 years. All patients received propranolol (median dose 65\u2009mg\/day). Flecainide (median dose 100\u2009mg\/day) was well tolerated, with no syncope or stress\u2010induced symptoms. Before flecainide, five patients (16%) experienced ventricular arrhythmic events recorded by the ICD, including two requiring appropriate shocks; no events occurred after treatment initiation. Both qualitative (2.07\u2009\u00b1\u20090.77 vs. 1.22\u2009\u00b1\u20091.08,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and quantitative (69.78\u2009\u00b1\u200983.17 vs. 15.29\u2009\u00b1\u20095.53,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) arrhythmic scores improved significantly. Additionally, maximum heart rate and the percentage of age\u2010predicted maximum heart rate were significantly reduced, while metabolic equivalents increased significantly (12.3\u2009\u00b1\u20093.8 vs. 14.7\u2009\u00b1\u20097.5;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.010).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In CPVT patients, the addition of flecainide to beta\u2010blocker therapy was associated with a significant reduction in arrhythmic burden and improvement in exercise\u2010related parameters during long\u2010term follow\u2010up.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jce.70429","type":"journal-article","created":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T22:03:57Z","timestamp":1782857037000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Long\u2010Term Serial Exercise Stress Testing in Catecholaminergic Polymorphic Ventricular Tachycardia on Beta\u2010Blocker and Flecainide Therapy"],"prefix":"10.1111","author":[{"given":"Fernando","family":"Wang\u00fcemert\u2010Perez","sequence":"first","affiliation":[{"name":"Cardiavant, Centro M\u00e9dico Cardiol\u00f3gico Las Palmas de Gran Canaria Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"German","family":"Ostos\u2010Ca\u00f1ero","sequence":"additional","affiliation":[{"name":"Cardiavant, Centro M\u00e9dico Cardiol\u00f3gico Las Palmas de Gran Canaria Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Wang\u00fcemert\u2010Guerra","sequence":"additional","affiliation":[{"name":"Cardiavant, Centro M\u00e9dico Cardiol\u00f3gico Las Palmas de Gran Canaria Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos","family":"Acosta\u2010Materan","sequence":"additional","affiliation":[{"name":"Cardiavant, Centro M\u00e9dico Cardiol\u00f3gico Las Palmas de Gran Canaria Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aridane","family":"C\u00e1rdenes\u2010le\u00f3n","sequence":"additional","affiliation":[{"name":"Cardiology Service Hospital Universitario de Gran Canaria Dr. Negr\u00edn Las Palmas de Gran Canaria Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eduardo","family":"Caballero\u2010Dorta","sequence":"additional","affiliation":[{"name":"Cardiology Service Hospital Universitario de Gran Canaria Dr. Negr\u00edn Las Palmas de Gran 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