"Ventricular pre-excitation can lead to symptomatic re-entrant
tachyarrhythmia in patients with mtDNA disease and is, in other patients, associated with
a small risk of sudden cardiac death. Consistent with international guidelines, and
following non-invasive assessment including an exercise ECG, consideration should
therefore be given to invasive electrophysiological study (EPS) in all patients with mtDNA
disease and non-intermittent pre-excitation.95,96 Asymptomatic
pre-excitation is a class IIa indication for EPS ± RFA in adults and class IIb in
children >5 years of age, but class III (i.e. "
[Show abstract][Hide abstract] ABSTRACT: Mitochondrial disease refers to a heterogenous group of genetic disorders that result
from dysfunction of the final common pathway of energy metabolism. Mitochondrial DNA
mutations affect key components of the respiratory chain and account for the majority of
mitochondrial disease in adults. Owing to critical dependence of the heart on oxidative
metabolism, cardiac involvement in mitochondrial disease is common and may occur as the
principal clinical manifestation or part of multisystem disease. Recent advances in our
understanding of the clinical spectrum and genetic aetiology of cardiac involvement in
mitochondrial DNA disease have important implications for cardiologists in terms of the
investigation and multi-disciplinary management of patients.
European Heart Journal 08/2012; 33(24). DOI:10.1093/eurheartj/ehs275 · 15.20 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The sudden death of a young athlete is a devastating event that impacts the lay public and medical community and has attracted efforts to screen for underlying cardiovascular diseases associated with sudden death in this population. Electrocardiography (ECG) screening has been shown to increase the sensitivity of finding structural heart diseases in competitive athletes. Recent research in diverse populations of athletes has led to refinements in ECG-interpretation standards designed to improve its diagnostic accuracy. This review summarizes relevant information regarding cardiovascular screening and ECG interpretation in athletes.
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