Long QT Syndrome risk stratification

Jump to navigation Jump to search

Long QT Syndrome Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Long QT Syndrome from other Diseases

Epidemiology and Demographics

Risk Stratification

Screening

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X-ray

CT scan

MRI

Other Imaging Findings

Other Diagnostic Studies

Genetic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Case Studies

Case #1

Long QT Syndrome risk stratification On the Web

Most recent articles

Most cited articles

Review articles

Programs

slides

[1]

American Roentgen Ray Society Images of Long QT Syndrome risk stratification

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

on Long QT Syndrome risk stratification

CDC onLong QT Syndrome risk stratification

QT Syndrome risk stratification in the news

on Long QT Syndrome risk stratification

Directions to Hospitals Treating Long QT Syndrome

Risk calculators and risk factors for Long QT Syndrome risk stratification

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [2]

Overview

The genetic variant (LQT1-8), the gender and the QT interval are associated with the risk of a cardiac event. A history of prior events (syncope, fainting spells, seizures, sudden death) and a family history of cardiac events are associated with an increased risk of subsequent cardiac events.

Risk Factors for Torsade de Pointes and Sudden Cardiac Death

  • Persons with a history of repeated fainting episodes or syncope. If there are more than 2 fainting spells in under 2 years, the risk of an aborted SCD or SCD is increased 18 fold.[1]
  • Repeated blackouts or fainting spells in the context of the following are due to a malignant arrhythmia until proven otherwise:
  • Exertion
  • Loud startling noise
  • Postpartum syncope
  • Seizures
  • A prior history of cardiac arrest.
  • Family members of persons with repeated fainting, accidents, seizures or a history of cardiac arrest.
  • Persons who are on certain medications that are known to cause a prolonged QT interval on electrocardiogram.
  • Persons who are first degree relatives of people with know long QT syndrome.
  • Persons who suffer from anorexia nervosa, or who have low levels of magnesium, calcium or potassium in their blood

Risk stratification

The risk for an untreated LQTS patients sustaining an events (syncope or cardiac arrest) can be predicted from their genotype (LQT1-8), gender and corrected QT interval.[2]

High risk

  • Risk of event: >50%

QTc > 500 msec LQT1 & LQT2 & LQT3(males)

Intermediate risk

  • Risk of event: 30-50%

QTc > 500 msec LQT3(females)

QTc < 500 msec LQT2(females)& LQT3

Low risk

  • Risk of event: <30%

QTc < 500 msec LQT1 & LQT2 (males)


Risk of Arrhythmias and Medications to be Avoided in Congenital Long QT Syndrome

References

  1. Hobbs et al. JAMA 296:1249-1254, 2006.
  2. Risk Stratification in the Long-QT Syndrome: N Engl J Med 2003; 349:908-909, Aug 28, 2003. PMID 12944579.