Abstract
Channelopathies are the leading causes of SCD in patients without structural heart disease. Missing the diagnosis of high-risk but concealed channelopathies could have lethal clinical consequences. However, the diagnosis of channelopathies is often challenging due to the dynamic clinical presentations and elusive ECG manifestations of these diseases. An integrated approach including clinical assessment, repeated electrocardiography, drug provocation tests, exercise stress test and genetic studies is often required for establishing the diagnosis. Pharmacological provocation tests may have limited sensitivity and may be associated with false positive results. Wide-spread use of genetic studies are limited by low yield, cost-effectiveness and availability issue. Variances of unknown significance could also complicate the interpretation of the genetic screening results. This article reviews the roles of exercise stress test in the diagnosis and risk stratification of patients with Brugada Syndrome, Long QT syndrome and catecholaminergic polymorphic ventricular tachycardia.
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