Sports Participation in Patients with Congenital Long QT Syndrome
| Autor: | Salima Bhimani, Peter F. Aziz, Jared Klein |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
congenital
hereditary and neonatal diseases and abnormalities medicine.medical_specialty biology Heart disease Athletes business.industry Propranolol medicine.disease biology.organism_classification Penetrance QT interval Sudden cardiac death Channelopathy Nadolol Internal medicine Cardiology medicine cardiovascular diseases business medicine.drug |
| Zdroj: | Sports Cardiology ISBN: 9783030693831 |
| DOI: | 10.1007/978-3-030-69384-8_11 |
| Popis: | Congenital long QT syndrome (LQTS) is an inherited channelopathy that can manifest as sudden cardiac death in the absence of morphologic heart disease. Corrected QT interval (QTc) is typically calculated using Bazett’s formula of QTc = QT interval/√RR on the 12-lead electrocardiogram (ECG). Suspicion for the diagnosis of LQTS should be based upon a QTc exceeding 470 milliseconds (ms) in males and 480 ms in females. About 75–80% of patients with LQTS have identifiable genetic variants with variable penetrance. The most common subtype is LQT1 in which arrhythmia is triggered by exercise, particularly swimming. The less common subtypes are LQT2 and LQT3 in which arrhythmias are triggered by auditory stimuli and during sleep, respectively. The mainstay of treatment for LQTS is beta blockers which have been shown to reduce the risk of sudden cardiac death. Nadolol and propranolol have been demonstrated to have the best efficacy. Sports participation guidelines have become less restrictive as studies have demonstrated that episodes of sudden cardiac death are not as high as previously thought, particularly with avoidance of QT prolonging medications and adherence to proper medical treatment with beta blockers. It is crucial to review risk stratification with athletes with LQTS and utilize shared decision making to come to a consensus for sports participation on a case-by-case basis. Safety precautions at practices and games must be utilized such as having an AED on-site, avoidance of dehydration, and establishing an emergency action plan with the appropriate school/team officials. |
| Databáze: | OpenAIRE |
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