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Review
. 2021 May 25;77(20):2573-2591.
doi: 10.1016/j.jacc.2021.03.325.

Precision Medicine Approaches to Cardiac Arrhythmias: JACC Focus Seminar 4/5

John R Giudicessi  1 , Michael J Ackerman  2 , Diane Fatkin  3 , Jason C Kovacic  4
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Free article
Review

Precision Medicine Approaches to Cardiac Arrhythmias: JACC Focus Seminar 4/5

John R Giudicessi et al. J Am Coll Cardiol. .
Free article

Erratum in

  • Correction.
    [No authors listed] [No authors listed] J Am Coll Cardiol. 2021 Jul 6;78(1):93. doi: 10.1016/j.jacc.2021.05.032. J Am Coll Cardiol. 2021. PMID: 34210423 No abstract available.

Abstract

In the initial 3 papers in this Focus Seminar series, the fundamentals and key concepts of precision medicine were reviewed, followed by a focus on precision medicine in the context of vascular disease and cardiomyopathy. For the remaining 2 papers, we focus on precision medicine in the context of arrhythmias. Specifically, in this fourth paper we focus on long QT syndrome, Brugada syndrome, and atrial fibrillation. The final (fifth) paper will deal with catecholaminergic polymorphic ventricular tachycardia. These arrhythmias represent a spectrum of disease ranging from common to relatively rare, with very different genetic and environmental causative factors, and with differing clinical manifestations that range from almost no consequences to lethality in childhood or adolescence if untreated. Accordingly, the emerging precision medicine approaches to these arrhythmias vary significantly, but several common themes include increased use of genetic testing, avoidance of triggers, and personalized risk stratification to guide the use of arrhythmia-specific therapies.

Keywords: Brugada syndrome; atrial fibrillation; cardiac arrhythmia; genetic testing; genetics; long QT syndrome; precision medicine; sudden cardiac death.

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Conflict of interest statement

Funding Support and Author Disclosures This work was supported by the Mayo Clinic Windland Smith Rice Comprehensive Sudden Cardiac Death Program. Dr. Fatkin has received support from the Victor Chang Cardiac Research Institute, Estate of the Late R.T. Hall, New South Wales Health, Australian Genomics, National Health and Medical Research Council of Australia. Dr. Kovacic has received research support from the National Institutes of Health (R01HL130423, R01HL135093, R01HL148167–01A1) and New South Wales Health (RG194194). Dr. Giudicessi has modest equity interest in 3M, GlaxoSmithKline, Medtronic, MyoKardia, and Pfizer. Dr. Ackerman is a consultant for Abbott, ARMGO Pharma, Audentes Therapeutics, Boston Scientific, Daiichi-Sankyo, Invitae, LQT Therapeutics, Medtronic, MyoKardia, and UpToDate; and he and the Mayo Clinic are involved in an equity/royalty relationship with AliveCor (AliveCor was not involved in this study).

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