Detection of spontaneous paroxysm of coronary spastic angina (CSA) is generally difficult because CSA paroxysms are transient and electrocardiograms in a non-paroxysmal state are normal. We recorded electrocardiograms when symptoms appeared using an event recorder, and investigated its usefulness for the diagnosis of CSA. The subjects were 38 patients (18 males and 20 females) with a mean age of 58.5±11.7 years (35-80 years) in whom CSA was diagnosed, or treatment was initiated after examination using a loop memory-type event recorder (CG-6106). Electrocardiographic ischemic changes were noted in 52.2%of 157 events, and 57.5±55.0 hours (mean) were taken to detect a finding. The findings were ST elevation in 13 patients, ST depression in 21, changes in T wave in 11, and appearance of negative U waves in 7 (including overlaps). Using an event recorder, we succeeded in detecting coronary spastic paroxysms, which is important for the diagnosis of CSA. An event recorder may be useful for the early diagnosis and treatment of CSA.

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In 20cases with clinically-diagnosed catecholaminergic polymorphic ventricular tachycardia (CPVT) from 12 unrelated Japanese families, we conducted genetic testing on RyR2, a gene encoding the cardiac ryanodine receptor. The correlation between RyR2−mutations and clinical phenotypes was investigated. The RyR2 mutations were found in 9 cases from the 20 probands (incidence : 45.0%) and in 3 from the 12 family members manifesting CPVT (incidence : 25.0%) Both bidirectional ventricular tachycardia (bVT) and atrial arrhythmias were significantly more frequent in RyR2-positive compared to RyR2-negative CPVT patients. The findings suggested that RyR2 mutations are closely related with bVT and atrial arrhythmias of early onset.

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[in Japanese]

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[in Japanese]

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[in Japanese]

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[in Japanese]

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