{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T09:49:27Z","timestamp":1769161767902,"version":"3.49.0"},"reference-count":24,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Arrhythmia and Electrophysiology"],"published-print":{"date-parts":[[2020,3]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>Risk stratification in catecholaminergic polymorphic ventricular tachycardia remains ill defined. Heart rate recovery (HRR) immediately after exercise is regulated by autonomic reflexes, particularly vagal tone, and may be associated with symptoms and ventricular arrhythmias in patients with catecholaminergic polymorphic ventricular tachycardia. Our objective was to evaluate whether HRR after maximal exercise on the exercise stress test (EST) is associated with symptoms and ventricular arrhythmias.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>In this retrospective observational study, we included patients \u226465 years of age with an EST without antiarrhythmic drugs who attained at least 80% of their age- and sex-predicted maximal HR. HRR in the recovery phase was calculated as the difference in heart rate (HR) at maximal exercise and at 1 minute in the recovery phase (\u0394HRR1\u2032).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>\n              We included 187 patients (median age, 36 years; 68 [36%] symptomatic before diagnosis). Pre-EST HR and maximal HR were equal among symptomatic and asymptomatic patients. Patients who were symptomatic before diagnosis had a greater \u0394HRR1\u2032 after maximal exercise (43 [interquartile range, 25\u201358] versus 25 [interquartile range, 19\u201334] beats\/min;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001). Corrected for age, sex, and relatedness, patients in the upper tertile for \u0394HRR1\u2032 had an odds ratio of 3.4 (95% CI, 1.6\u20137.4) of being symptomatic before diagnosis (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001). In addition, \u0394HRR1\u2032 was higher in patients with complex ventricular arrhythmias at EST off antiarrhythmic drugs (33 [interquartile range, 22\u201348] versus 27 [interquartile range, 20\u201336] beats\/min;\n              <jats:italic>P<\/jats:italic>\n              =0.01). After diagnosis, patients with a \u0394HRR1\u2032 in the upper tertile of its distribution had significantly more arrhythmic events as compared with patients in the other tertiles (\n              <jats:italic>P<\/jats:italic>\n              =0.045).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>Catecholaminergic polymorphic ventricular tachycardia patients with a larger HRR following exercise are more likely to be symptomatic and have complex ventricular arrhythmias during the first EST off antiarrhythmic drug.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circep.119.007471","type":"journal-article","created":{"date-parts":[[2020,2,16]],"date-time":"2020-02-16T20:07:56Z","timestamp":1581883676000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":14,"title":["Heart Rate Recovery After Exercise Is Associated With Arrhythmic Events in Patients With Catecholaminergic Polymorphic Ventricular Tachycardia"],"prefix":"10.1161","volume":"13","author":[{"given":"Krystien V.V.","family":"Lieve","sequence":"first","affiliation":[{"name":"Department of Clinical and Experimental Cardiology, Heart Center (K.V.V.L., C.v.d.W., N.H., S.-A.B.C., A.A.M.W.), the Netherlands."},{"name":"European Reference Network \u2018ERN GUARD-Heart\u2019 (K.V.V.L., V.D., C.v.d.W., A.D., I.D., H.B., F.R.I.N., T.R., N.H., J.T., J.T.-H., V.P., A.L., H.S., P.J.S., A.A.M.W.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Veronica","family":"Dusi","sequence":"additional","affiliation":[{"name":"European Reference Network \u2018ERN GUARD-Heart\u2019 (K.V.V.L., V.D., C.v.d.W., A.D., I.D., H.B., F.R.I.N., T.R., N.H., J.T., J.T.-H., V.P., A.L., H.S., P.J.S., A.A.M.W.)."},{"name":"Department of Molecular Medicine, Section of Cardiology, University of Pavia, Italy (V.D.)."},{"name":"Cardiac Intensive Care Unit, Arrhythmia and Electrophysiology and Experimental Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy (V.D.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian","family":"van der Werf","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Cardiology, Heart Center (K.V.V.L., C.v.d.W., N.H., S.-A.B.C., A.A.M.W.), the Netherlands."},{"name":"European Reference Network \u2018ERN GUARD-Heart\u2019 (K.V.V.L., V.D., C.v.d.W., A.D., I.D., H.B., F.R.I.N., T.R., N.H., J.T., J.T.-H., V.P., A.L., H.S., P.J.S., A.A.M.W.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. Martijn","family":"Bos","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Division of Heart Rhythm Services (J.M.B., C.M.L., M.J.A.), Mayo Clinic, Rochester, MN."},{"name":"Department of Pediatric and Adolescent Medicine, Division of Pediatric Cardiology (J.M.B., C.M.L., M.J.A.), Mayo Clinic, Rochester, MN."},{"name":"Department of Molecular Pharmacology and Experimental Therapeutics, Windland Smith Rice Sudden Death Genomics Laboratory (J.M.B., C.M.L., M.J.A.), Mayo Clinic, Rochester, MN."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Conor M.","family":"Lane","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Division of Heart Rhythm Services (J.M.B., C.M.L., M.J.A.), Mayo Clinic, Rochester, MN."},{"name":"Department of Pediatric and Adolescent Medicine, Division of Pediatric Cardiology (J.M.B., C.M.L., M.J.A.), Mayo Clinic, Rochester, MN."},{"name":"Department of Molecular Pharmacology and Experimental Therapeutics, Windland Smith Rice Sudden Death Genomics Laboratory (J.M.B., C.M.L., M.J.A.), Mayo Clinic, Rochester, MN."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mathis Korseberg","family":"Stokke","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Center for Cardiological Innovation, Oslo University Hospital, Rikshospitalet, University of Oslo, Norway (M.K.S., K.H.H.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas M.","family":"Roston","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Children\u2019s Heart Centre, Division of Cardiology, British Columbia Children\u2019s Hospital, Vancouver, BC, Canada (T.M.R., S.S.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aurora","family":"Djupsj\u00f6backa","sequence":"additional","affiliation":[{"name":"European Reference Network \u2018ERN GUARD-Heart\u2019 (K.V.V.L., V.D., C.v.d.W., A.D., I.D., H.B., F.R.I.N., T.R., N.H., J.T., J.T.-H., V.P., A.L., H.S., P.J.S., A.A.M.W.)."},{"name":"Heart and Lung Center, Helsinki University Hospital, Helsinki University, Finland (A.D., H.S.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuko","family":"Wada","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Shiga University of Medical Science, Otsu, Japan (Y.W., M.H.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isabelle","family":"Denjoy","sequence":"additional","affiliation":[{"name":"European Reference Network \u2018ERN GUARD-Heart\u2019 (K.V.V.L., V.D., C.v.d.W., A.D., I.D., H.B., F.R.I.N., T.R., N.H., J.T., J.T.-H., V.P., A.L., H.S., P.J.S., A.A.M.W.)."},{"name":"CNMR Maladies Cardiaques H\u00e9r\u00e9ditaires Rares, H\u00f4pital Bichat, Paris, France (I.D., A.L.)."},{"name":"Universit\u00e9 Paris Diderot, Sorbonne Paris Cit\u00e9, France (I.D., A.L.)."},{"name":"AP-HP, Service de Cardiologie, H\u00f4pital Bichat, Paris, 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J.T.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6441-274X","authenticated-orcid":false,"given":"Christopher","family":"Semsarian","sequence":"additional","affiliation":[{"name":"Agnes Ginges Center for Molecular Cardiology, Centenary Institute, University of Sydney, Australia (C.S.)."},{"name":"Department of Cardiology, Royal Prince Alfred Hospital, Camperdown, NSW, Australia (C.S.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8676-4874","authenticated-orcid":false,"given":"Tomas","family":"Robyns","sequence":"additional","affiliation":[{"name":"European Reference Network \u2018ERN GUARD-Heart\u2019 (K.V.V.L., V.D., C.v.d.W., A.D., I.D., H.B., F.R.I.N., T.R., N.H., J.T., J.T.-H., V.P., A.L., H.S., P.J.S., A.A.M.W.)."},{"name":"Department of Cardiovascular Diseases, University Hospitals Leuven, Belgium 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Netherlands."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frederic","family":"Sacher","sequence":"additional","affiliation":[{"name":"Bordeaux University Hospital, LIRYC Institute, Pessac, France (F.S.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jan","family":"Till","sequence":"additional","affiliation":[{"name":"European Reference Network \u2018ERN GUARD-Heart\u2019 (K.V.V.L., V.D., C.v.d.W., A.D., I.D., H.B., F.R.I.N., T.R., N.H., J.T., J.T.-H., V.P., A.L., H.S., P.J.S., A.A.M.W.)."},{"name":"Department of Cardiology, Royal Brompton Hospital, London, United Kingdom (F.R.I.N., J.T.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3653-0412","authenticated-orcid":false,"given":"Jonathan R.","family":"Skinner","sequence":"additional","affiliation":[{"name":"The Green Lane Paediatric and Congenital Cardiac Services, Starship Children\u2019s Hospital and Department of Paediatrics Child and Youth 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