The goal of this observational study is to evaluate exercise testing and daily physical activity in children and adolescents who are diagnosed with an inherited arrhythmia.
The main question it aims to answer is: Does maximum heart rate during controlled exercise tolerance testing accurately reflect maximum heart rate and peak exercise levels during free living daily physical activity in children and adolescents diagnosed with an inherited arrhythmia?
Participants will:
* Complete routine exercise tolerance testing * Record daily physical activity and exercise over two weeks, while wearing an activity and heart rate monitor and digit diary. * Complete a physical activity questionnaire at the end of two weeks.
Male and female children
Aged 6-16 years
Diagnosed with long QT syndrome or catecholaminergic polymorphic ventricular tachycardia
Treated with beta-blocker and/or sodium channel blockade
Children aged less than 6 years
Adults, 17 years of age and above
Unable to run on an exercise treadmill due to physical limitations.
Individuals unable to speak or understand English, due to no translation service available.
Affected cohort: 60 children aged 6-16 years, diagnosed with inherited arrhythmias (IAS) Unaffected cohort: 50 healthy children aged 6-16 years (siblings of affected children and those undergoing screening for inherited arrhythmias)
Other
Prospective
Exercise tolerance test
Diagnostic testClinical routine exercise tolerance test using an exercise treadmill, according to the arrhythmia protocol (15 minute protocol utilising increasing speed and incline with a 6 minute recovery)
Physical activity & heart rate monitoring
Other interventionPhysical activity monitoring over two weeks using Actiheart and Pro-Diary monitors to record heart rate, heart rhythm, activities engaged in and estimated intensity of activities.
Correlation of maximum heart rate during clinical exercise tolerance test and daily physical activity
Assess the correlation between maximum heart rate (HRmax) obtained during controlled exercise tolerance test (ETT) and wearable heart rate devices during daily free-living (FL) physical activity (PA) and exercise.
Physical activity questionnaire
Investigate actual versus reported PA children engage in using a questionnaire to record accuracy of child/parent recall of the type and intensity of PA.
Heart rate assessment during exercise tolerance testing
Assess differences in HRmax relative to age of children completing three ETT protocols i. Bruce/modified Bruce with accelerated sprint - Evelina London Children's Hospital (ELCH) ii. Arrhythmia high intensity (HIT) - Royal Brompton Hospital (RBH) iii. Arrhythmia - Great Ormond Street Hospital (GOSH)
Comparison of exercise tolerance testing protocols
To compare protocols between the centres to determine if one protocol correlates more closely with HRmax (protocol completion or no further rise in HR despite increasing workload) achieved during FL PA.
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Royal Brompton & Harefield NHS Foundation Trust
Lead sponsor
Great Ormond Street Hospital for Children NHS Foundation Trust
Collaborator
Guy's and St Thomas' NHS Foundation Trust
Collaborator
