Atlas Protocol · Clinical Prevention

Atlas Malignant Hyperthermia Module

2-gene panel for malignant hyperthermia susceptibility (RYR1, CACNA1S).

A 2-gene panel for malignant hyperthermia susceptibility, covering RYR1 and CACNA1S — relevant before any planned general anaesthesia, especially with a personal or family history.

GenDG §10

Bookable, after medical review.

Before the analysis, a specialist in human genetics reviews your preparation questionnaire and informs you (GenDG). If the test is declined, Atlas refunds the full amount.

HOW IT WORKS

How it works.

  1. 01

    Pay

    You pay Atlas for Atlas Baseline and the analysis.

  2. 02

    Questionnaire and physician review

    You receive a questionnaire by email from the physician's practice, and a specialist in human genetics reviews it. If the test is declined, you get a full automatic refund.

  3. 03

    Counselling slot

    You choose a counselling slot or join the waitlist.

  4. 04

    Consent, kit and result

    After the counselling you give your consent, then we ship your collection kit. The physician discusses the result with you.

WHICH PART OF YOUR BODY

Which part of your body.

  • Skeletal muscle (under anesthesia)
WHAT THIS PANEL ANSWERS

What this panel answers.

Do you carry inherited variants that cause a dangerous reaction to common anesthetic drugs?

WHAT CHANGES IF A FINDING IS IDENTIFIED

What changes if something is found.

  1. Carriers must inform every anesthesiology team before any planned surgery, including elective procedures, dental surgery under general anesthesia, and caesarean section.
  2. Safe alternative anesthetic agents exist and are routine.
  3. Without disclosure, exposure to volatile anesthetics or succinylcholine can trigger a life-threatening hyperthermic crisis. With disclosure, surgery is routine and safe.
  4. Family cascade testing is straightforward and relevant for any relative who may have surgery.
Pathway references
  • GenDG §7
GENES ANALYZED

What is analyzed.

Atlas analyzes each gene in its entirety -- not just hotspot regions -- against current clinical literature. Findings are assessed by a specialist in human genetics before release.

Malignant Hyperthermia Susceptibility

2 genes

A 2-gene panel for malignant hyperthermia susceptibility. Variants in RYR1 or CACNA1S predispose to a rare but life-threatening hypermetabolic reaction triggered by volatile anesthetics (halothane, isoflurane, sevoflurane, desflurane) and the muscle relaxant succinylcholine.

Clinical areas covered
  • Anesthesia-triggered malignant hyperthermia -- volatile agents and succinylcholine
Analyzed genes -- 2 genes
  • CACNA1S
  • RYR1

Gene list version 2026-05.

WHY THIS MATTERS

Why early knowledge matters.

  • Malignant Hyperthermia Susceptibility

    Pre-surgical knowledge of carrier status lets an anesthesiologist choose safe agents in advance. The finding is particularly relevant for elective surgery and for family planning around procedures like Caesarean delivery, where general anesthesia may be required at short notice.

RESULT INTERPRETATION

How findings are reported.

Every Atlas predictive report uses the same five-outcome framework so you and your physician can read it the same way each time.

  1. 01

    Pathogenic variant

    Increased disease risk. The report includes an individualized prevention plan and a recommendation to discuss next steps with a physician or medical geneticist.

  2. 02

    Likely pathogenic variant

    Probable disease association. Preventive monitoring is typically justified; the strength of evidence is documented in the report.

  3. 03

    Variant of uncertain significance (VUS)

    Reported but not currently actionable. A VUS may be reclassified over time as new evidence accumulates -- Atlas does not act on VUS findings without specialist review.

  4. 04

    No relevant variant in this panel

    No pathogenic or likely-pathogenic variant was identified in the analyzed genes. This does not eliminate all genetic risk -- only the genes in this panel were assessed.

  5. 05

    Family implications

    When an actionable variant is found, cascade testing of first-degree relatives is typically recommended -- a decision made together with a counselor.

Module-specific implications

  • Malignant Hyperthermia Susceptibility

    • A positive finding is documented in your medical record and shared with any anesthesiology team ahead of a planned procedure.
    • First-degree relatives may benefit from cascade testing -- the trait is autosomal dominant.
Counseling and cascade testing

Predictive genetic testing in Germany requires consultation with a physician qualified in human genetics under §7 of the GenDG (Arztvorbehalt). This counseling, before and after the test, is given by a specialist in human genetics. When an actionable finding has implications for relatives, this physician discusses cascade testing with you, not Atlas alone.

CLINICAL LIMITATIONS

What this test does not do.

  • Not a diagnosis of active disease

    A variant indicates predisposition. It does not confirm a condition is currently present.

  • Does not replace screening or routine care

    Imaging, lab work, and physical examination remain part of clinical care. Atlas results inform them; they do not substitute for them.

  • Not all risk is genetic

    Environment, behavior, age, and chance contribute to most common conditions. A genetic test reads one input.

  • A negative result does not eliminate risk

    Only the genes on the panel were analyzed. Variants in other genes, in non-coding regions, and outside the assay's technical scope are not assessed.

  • Clinical decisions remain with your physician

    Atlas reports are designed to be reviewed with a physician or medical geneticist. We do not recommend acting on a finding without that conversation.

GenDG §7

Predictive panels on this page are GenDG §7 Arztvorbehalt: counseling with a qualified human-genetics physician is required before and after the test. This counseling is given by a specialist in human genetics.

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