IMR Press / RCM / Volume 23 / Issue 8 / DOI: 10.31083/j.rcm2308276
Open Access Original Research
Clinical Characteristics, Genetic Basis and Healthcare Resource Utilisation and Costs in Patients with Catecholaminergic Polymorphic Ventricular Tachycardia: A Retrospective Cohort Study
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1 Cardiac Electrophysiology Unit, Cardiovascular Analytics Group, Laboratory of Cardiovascular Physiology, 999077 Hong Kong, China
2 School of Data Science, City University of Hong Kong, 999077 Hong Kong, China
3 Faculty of Health and Medical Sciences, University of Surrey, GU2 7XH Guildford, UK
4 State Key Laboratory of Agrobiotechnology (CUHK), School of Life Sciences, Chinese University of Hong Kong, 999077 Hong Kong, China
5 Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, 300211 Tianjin, China
*Correspondence: garytse86@gmail.com (Gary Tse)
§joint first authors.
Academic Editor: Konstantinos P. Letsas
Rev. Cardiovasc. Med. 2022, 23(8), 276; https://doi.org/10.31083/j.rcm2308276
Submitted: 14 March 2022 | Revised: 31 May 2022 | Accepted: 20 June 2022 | Published: 5 August 2022
(This article belongs to the Special Issue Risk Stratification in Cardiovascular Diseases)
Copyright: © 2022 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.
Abstract

Background: This study examined the clinical characteristics, genetic basis, healthcare utilisation and costs of catecholaminergic ventricular tachycardia (CPVT) patients from a Chinese city. Methods: This was a territory-wide retrospective cohort study of consecutive CPVT patients at public hospitals or clinics in Hong Kong. Healthcare resource utilisation for accident and emergency (A&E), inpatient and outpatient attendances were analysed over 19 years (2001–2019) followed by calculations of annualised costs (in USD). Results: Sixteen patients with a median presentation age (interquartile range (IQR) of 11 (9–14) years old) were included. Fifteen patients (93.8%) were initially symptomatic. Ten patients had both premature ventricular complexes (PVCs) and ventricular tachycardia/fibrillation (VT/VF). One patient had PVCs without VT/VF. Genetic tests were performed on 14 patients (87.5%). Eight (57.1%) tested positive for the ryanodine receptor 2 (RyR2) gene. Seven variants have been described elsewhere (c.14848G>A, c.12475C>A, c.7420A>G, c.11836G>A, c.14159T>C, c.10046C>T and c.7202G>A). c.14861C>G is a novel RyR2 variant not been reported outside this cohort. Patients were treated with beta-blockers (n = 16), amiodarone (n = 3) and verapamil (n = 2). Sympathectomy (n = 8) and implantable-cardioverter defibrillator implantation (n = 3) were performed. Over a median follow-up of 13.3 years (IQR: 8.4–18.1) years, six patients exhibited incident VT/VF. At the patient level, the median (IQR) annualised costs for A&E, inpatient and outpatient attendances were $66 (40–95), $10521 (5240–66887) and $791 (546–1105), respectively. Conclusions: All patients presented before the age of 19. The yield of genetic testing was 57%. The most expensive attendance type was inpatient stays, followed by outpatients and A&E attendances.

Keywords
CPVT
HCRU
tachycardia
genetics
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