Table of contents
Long QT syndrome
What's new
Added 2022 ESC, 2018 AHA/ACC/HRS and 2013 HRS/EHRA/APHRS guidelines for the diagnosis and management of long QT syndrome.
Guidelines
Key sources
The following summarized guidelines for the evaluation and management of long QT syndrome are prepared by our editorial team based on guidelines from the Global Initiative for Asthma (GINA 2024), the European Society of Cardiology (ESC 2022,2018), the American Heart Association (AHA 2020), the American Academy of Neurology (AAN 2019), the American Heart Association (AHA/HRS/ACC 2018), the Asia Pacific Heart...
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Screening and diagnosis
Classification and risk stratification
Diagnostic investigations
ECG: as per ACC/AHA/HRS 2018 guidelines, Consider obtaining ambulatory ECG monitoring, exercise treadmill testing, and/or recording the ECG lying and immediately on standing for establishing a diagnosis and monitoring the response to therapy in patients with suspected long QT syndrome.
C
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Epinephrine challenge testing
Genetic testing
Diagnostic procedures
Medical management
Avoidance of triggers/aggravators: as per GINA 2024 guidelines, Obtain an ECG for long QTc before initiating long-term azithromycin in patients with persistent symptomatic asthma, and reassess after a month on treatment.
B
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Beta-blockers
Sodium channel blockers
Intravenous magnesium
Therapeutic procedures
Surgical interventions
Left cardiac sympathetic denervation
As per ESC 2022 guidelines:
Perform left cardiac sympathetic denervation in patients with symptomatic long QT syndrome when:
ICD therapy is contraindicated or declined
patient is on β-blockers and genotype-specific drugs with an ICD and experiences multiple shocks or syncope due to ventricular arrhythmia
B
Consider performing either ICD placement or left cardiac sympathetic denervation in patients with symptomatic long QT syndrome when β-blockers and genotype-specific therapies are not tolerated or contraindicated at therapeutic doses.
C