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Long QT Syndrome

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Part of the book series: Contemporary Cardiology ((CONCARD))

Abstract

Over the past half century, LQTS has matriculated through several critical milestones including its sentinel clinical description, clinical diagnostic scorecard, pathogenetic discovery, decade of research-based genetic testing and genotype–phenotype correlations, and clinical availability of genetic testing. In this chapter, we will discuss the history, epidemiology, and clinical presentations of congenital long QT syndrome (LQTS). We will clarify current diagnostic approaches to LQTS, including clinical history and specific diagnostic testing. Treatment strategies including pharmacologic and surgical techniques will be examined, as well as the role of individualized treatment for the LQTS patient. Finally, preventative strategies will be discussed, including athletic participation.

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References

  1. Jervell A, Lange-Nielsen F (1957) Congenital deaf-mutism, functional heart disease with prolongation of the QT interval, and sudden death. Am Heart J 54

    Google Scholar 

  2. Romano C, Gemme G, Pongiglione R (1963) Aritmie cardiache rare dell’eta’pediatrica. II. Accessi sincopali per fibrillazione ventricolare parossistica. Clin Peditr (Bologna) 45:656–683

    CAS  Google Scholar 

  3. Ward OC (1964) A new famillial cardiac syndrome in children. J Irish Med Assoc 54:103–106

    CAS  Google Scholar 

  4. Curran, ME, Splawski I, Timothy KW et al (1995) A molecular basis for cardiac arrhythmia: HERG mutations cause long QT syndrome. Cell 80:795–803

    Article  PubMed  CAS  Google Scholar 

  5. Wang Q, Shen J, Splawski I et al (1995) SCN5A mutations associated with an inherited cardiac arrhythmia, long QT syndrome. Cell 80:805–811

    Article  PubMed  CAS  Google Scholar 

  6. Wang Q, Curran ME, Splawski I et al (1996) Positional cloning of a novel potassium channel gene: KVLQT1 mutations cause cardiac arrhythmias. Nat Genet 12:17–23

    Article  PubMed  Google Scholar 

  7. Zipes DP, Camm AJ, Borggrefe M et al (2006) ACC/AHA/ESC 2006 guidelines for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: a report of the American college of cardiology/American heart association task force and the European society of cardiology committee for practice guidelines (writing committee to develop guidelines for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death). J Am Coll Cardiol 48:1064–1108

    Article  Google Scholar 

  8. Ackerman MJ (2004) Cardiac channelopathies: it’s in the genes. Nat Med 10:463–464

    Article  PubMed  CAS  Google Scholar 

  9. Tester DJ, Will ML, Haglund CM et al (2006) Effect of clinical phenotype on yield of long QT syndrome genetic testing. J Am Coll Cardiol 47:764–768

    Article  PubMed  Google Scholar 

  10. Chen L, Marquardt ML, Tester DJ et al (2007) Mutation of an A-kinase-anchoring protein causes long-QT syndrome. Proc Natl Acad Sci USA 104:20990–20995

    Article  PubMed  CAS  Google Scholar 

  11. Medeiros-Domingo, A, Kaku, T, Tester, DJ et al (2007) SCN4B-encoded sodium channel beta4 subunit in congenital long-QT syndrome. Circulation 116:134–142

    Article  PubMed  Google Scholar 

  12. Ueda K, Valdivia C, Medeiros-Domingo A et al (2008) Syntrophin mutation associated with long QT syndrome through activation of the nNOS-SCN5A macromolecular complex. Proc Natl Acad Sci USA 105:9355–9360

    Article  PubMed  CAS  Google Scholar 

  13. Splawski I, Tristani-Firouzi M, Lehmann MH et al (1997) Mutations in the hminK gene cause long QT syndrome and suppress IKs function. Nat Genet 17:338–340

    Article  PubMed  CAS  Google Scholar 

  14. Abbott GW, Sesti F, Splawski I et al (1999) MiRP1 forms IKr potassium channels with HERG and is associated with cardiac arrhythmia. Cell 97:175–187

    Article  PubMed  CAS  Google Scholar 

  15. Mohler PJ, Schott JJ, Gramolini AO et al (2003) Ankyrin-B mutation causes type 4 long-QT cardiac arrhythmia and sudden cardiac death. Nature 421:634–639

    Article  PubMed  CAS  Google Scholar 

  16. Vatta M, Ackerman MJ, Ye B et al (2006) Mutant caveolin-3 induces persistent late sodium current and is associated with long-QT syndrome. Circulation 114:2104–2112

    Article  PubMed  CAS  Google Scholar 

  17. Zhang L, Benson DW, Tristani-Firouzi M et al (2005) Electrocardiographic features in Andersen-Tawil syndrome patients with KCNJ2 mutations: characteristic T-U-wave patterns predict the KCNJ2 genotype. Circulation 111:2720–2726

    Article  PubMed  Google Scholar 

  18. Splawski I, Timothy KW, Sharpe LM et al (2004) Ca(V)1.2 calcium channel dysfunction causes a multisystem disorder including arrhythmia and autism. Cell 119:19–31

    Article  PubMed  CAS  Google Scholar 

  19. Schwartz PJ, Stramba-Badiale M, Crotti L et al (2009) Prevalence of the congenital long-QT syndrome. Circulation 120:1761–1767

    Article  PubMed  Google Scholar 

  20. Tester DJ, Ackerman MJ (2007) Postmortem long QT syndrome genetic testing for sudden unexplained death in the young. J Am Coll Cardiol 49:240–246

    Article  PubMed  Google Scholar 

  21. Arnestad M, Crotti L, Rognum TO et al (2007) Prevalence of long-QT syndrome gene variants in sudden infant death syndrome. Circulation 115:361–367

    Article  PubMed  Google Scholar 

  22. Goldenberg I, Moss AJ, Zareba W et al (2006) Clinical course and risk stratification of patients affected with the Jervell and Lange-Nielsen syndrome. J Cardiovasc Electrophysiol 17:1161–1168

    Article  PubMed  Google Scholar 

  23. Goldenberg I, Moss AJ, Bradley J et al (2008) Long-QT syndrome after age 40. Circulation 117:2192–2201

    Article  PubMed  Google Scholar 

  24. Goldenberg I, Moss AJ, Peterson DR et al (2008) Risk factors for aborted cardiac arrest and sudden cardiac death in children with the congenital long-QT syndrome. Circulation 117:2184–2191

    Article  PubMed  Google Scholar 

  25. Spazzolini C, Mullally J, Moss AJ et al (2009) Clinical implications for patients with long QT syndrome who experience a cardiac event during infancy. J Am Coll Cardiol 54:832–837

    Article  PubMed  Google Scholar 

  26. Hobbs JB, Peterson DR, Moss AJ et al (2006) Risk of aborted cardiac arrest or sudden cardiac death during adolescence in the long-QT syndrome. JAMA 296:1249–1254

    Article  PubMed  CAS  Google Scholar 

  27. Sauer AJ, Moss AJ, McNitt S et al (2007) Long QT syndrome in adults. J Am Coll Cardiol 49:329–337

    Article  PubMed  Google Scholar 

  28. Moss AJ, Robinson JL (1992) Clinical aspects of the idiopathic long QT syndrome. Ann NY Acad Sci 644:103–111

    Article  PubMed  CAS  Google Scholar 

  29. Vincent GM, Timothy K, Fox J et al (1999) The inherited long QT syndrome: from ion channel to bedside. Cardiol Rev 7:44–55

    Article  PubMed  CAS  Google Scholar 

  30. Moss AJ, Schwartz PJ, Crampton RS et al (1991) The long QT syndrome. Prospective longitudinal study of 328 families. Circulation 84:1136–1144

    Article  PubMed  CAS  Google Scholar 

  31. Rashba EJ, Zareba W, Moss AJ et al (1998) Influence of pregnancy on the risk for cardiac events in patients with hereditary long QT syndrome. LQTS investigators. Circulation 97:451–456

    Article  PubMed  CAS  Google Scholar 

  32. Schwartz PJ, Priori SG, Spazzolini C et al (2001) Genotype-phenotype correlation in the long-QT syndrome: gene-specific triggers for life-threatening arrhythmias. Circulation 103:89–95

    Article  PubMed  CAS  Google Scholar 

  33. Ackerman MJ, Tester DJ, Porter CJ (1999) Swimming, a gene-specific arrhythmogenic trigger for inherited long QT syndrome. Mayo Clin Proc 74:1088–1094

    Article  PubMed  CAS  Google Scholar 

  34. Moss AJ, Zareba W, Benhorin J et al (1995) ECG T-wave patterns in genetically distinct forms of the hereditary long QT syndrome. Circulation 92:2929–2934

    Article  PubMed  CAS  Google Scholar 

  35. Zhang L, Timothy KW, Vincent GM et al (2000) Spectrum of ST-T-wave patterns and repolarization parameters in congenital long-QT syndrome: ECG findings identify genotypes. Circulation 102:2849–2855

    Article  PubMed  CAS  Google Scholar 

  36. Wilde AA, Jongbloed RJ, Doevendans PA et al (1999) Auditory stimuli as a trigger for arrhythmic events differentiate HERG-related (LQTS2) patients from KVLQT1-related patients (LQTS1). J Am Coll Cardiol 33:327–332

    Article  PubMed  CAS  Google Scholar 

  37. Khositseth A, Tester DJ, Will ML et al (2004) Identification of a common genetic substrate underlying postpartum cardiac events in congenital long QT syndrome. Heart Rhythm 1:60–64

    Article  PubMed  Google Scholar 

  38. Johnson JN, Hofman N, Haglund CM et al (2009) Identification of a possible pathogenic link between congenital long QT syndrome and epilepsy. Neurology 72:224–231

    Article  PubMed  CAS  Google Scholar 

  39. Zareba W, Moss AJ, Schwartz PJ et al (1998) Influence of genotype on the clinical course of the long-QT syndrome. International long-QT syndrome registry research group. N Engl J Med 339:960–965

    Article  PubMed  CAS  Google Scholar 

  40. Schwartz PJ (1985) Idiopathic long QT syndrome: progress and questions. Am Heart J 109:399–411

    Article  PubMed  CAS  Google Scholar 

  41. Schwartz PJ, Moss AJ, Vincent GM et al (1993) Diagnostic criteria for the long QT syndrome. An update. Circulation 88:782–784

    Article  PubMed  CAS  Google Scholar 

  42. Taggart NW, Haglund CM, Tester DJ et al (2007) Diagnostic miscues in congenital long-QT syndrome. Circulation 115:2613–2620

    Article  PubMed  Google Scholar 

  43. Viskin S, Rosovski U, Sands AJ et al (2005) Inaccurate electrocardiographic interpretation of long QT: the majority of physicians cannot recognize a long QT when they see one. Heart Rhythm 2:569–574

    Article  PubMed  Google Scholar 

  44. Postema PG, De Jong JS, Van der Bilt IA et al (2008) Accurate electrocardiographic assessment of the QT interval: teach the tangent. Heart Rhythm 5:1015–1018

    Article  PubMed  Google Scholar 

  45. Davey P (1999) A new physiological method for heart rate correction of the QT interval. Heart 82:183–186

    PubMed  CAS  Google Scholar 

  46. Sagie A, Larson MG, Goldberg RJ et al (1992) An improved method for adjusting the QT interval for heart rate (the Framingham heart study). Am J Cardiol 70:797–801

    Article  PubMed  CAS  Google Scholar 

  47. Fridericia L (1920) The duration of systole in the electrocardiogram of normal subjects and of patients with heart disease. Acta Medica Scandinavica 469–486

    Google Scholar 

  48. Bazett H (1920) An analysis of the time-relations of electrocardiograms. Heart 353–370

    Google Scholar 

  49. Vincent GM, Richard J (2001) Calculation of the QTc interval during sinus arrhythmia in patients suspected to have long QT syndrome. Circulation 104:II-690–II-691

    Google Scholar 

  50. Martin AB, Perry JC, Robinson JL et al (1995) Calculation of QTc duration and variability in the presence of sinus arrhythmia. Am J Cardiol 75:950–952

    Article  PubMed  CAS  Google Scholar 

  51. Goldenberg I, Moss AJ, Zareba W (2006) QT interval: how to measure it and what is "normal". J Cardiovasc Electrophysiol 17:333–336

    Article  PubMed  Google Scholar 

  52. Basavarajaiah S, Wilson M, Whyte G et al (2007) Prevalence and significance of an isolated long QT interval in elite athletes. Eur Heart J 28:2944–2949

    Article  PubMed  Google Scholar 

  53. Levine E, Rosero SZ, Budzikowski AS et al (2008) Congenital long QT syndrome: considerations for primary care physicians. Cleve Clin J Med 75:591–600

    Article  PubMed  Google Scholar 

  54. Merri M, Benhorin J, Alberti M et al (1989) Electrocardiographic quantitation of ventricular repolarization. Circulation 80:1301–1308

    Article  PubMed  CAS  Google Scholar 

  55. Rautaharju PM, Surawicz B, Gettes LS et al (2009) AHA/ACCF/HRS recommendations for the standardization and interpretation of the electrocardiogram: part IV: the ST segment, T and U waves, and the QT interval: a scientific statement from the American heart association electrocardiography and arrhythmias committee, council on clinical cardiology; the American college of cardiology foundation; and the heart rhythm society. Endorsed by the international society for computerized electrocardiology. J Am Coll Cardiol 53:982–991

    Article  PubMed  Google Scholar 

  56. Lupoglazoff JM, Denjoy I, Berthet M et al (2001) Notched T waves on Holter recordings enhance detection of patients with LQt2 (HERG) mutations. Circulation 103:1095–1101

    Article  PubMed  CAS  Google Scholar 

  57. Khositseth A, Hejlik J, Shen WK et al (2005) Epinephrine-induced T-wave notching in congenital long QT syndrome. Heart Rhythm 2:141–146

    Article  PubMed  Google Scholar 

  58. Schwartz PJ, Malliani A (1975) Electrical alternation of the T-wave: clinical and experimental evidence of its relationship with the sympathetic nervous system and with the long Q-T syndrome. Am Heart J 89:45–50

    Article  PubMed  CAS  Google Scholar 

  59. Zareba W, Moss AJ, le Cessie S et al (1994) T wave alternans in idiopathic long QT syndrome. J Am Coll Cardiol 23:1541–1546

    Article  PubMed  CAS  Google Scholar 

  60. Napolitano C, Priori SG, Schwartz PJ (2000) Significance of QT dispersion in the long QT syndrome. Prog Cardiovasc Dis 42:345–350

    Article  PubMed  CAS  Google Scholar 

  61. Day CP, McComb JM, Campbell RW (1990) QT dispersion: an indication of arrhythmia risk in patients with long QT intervals. Br Heart J 63:342–344

    Article  PubMed  CAS  Google Scholar 

  62. Priori SG, Napolitano C, Diehl L et al (1994) Dispersion of the QT interval. A marker of therapeutic efficacy in the idiopathic long QT syndrome. Circulation 89:1681–1689

    Article  PubMed  CAS  Google Scholar 

  63. Moennig G, Schulze-Bahr E, Wedekind H et al (2001) Clinical value of electrocardiographic parameters in genotyped individuals with familial long QT syndrome. Pacing Clin Electrophysiol 24:406–415

    Article  PubMed  CAS  Google Scholar 

  64. Vincent GM, Jaiswal D, Timothy KW (1991) Effects of exercise on heart rate, QT, QTc and QT/QS2 in the Romano- Ward inherited long QT syndrome. Am J Cardiol 68:498–503

    Article  PubMed  CAS  Google Scholar 

  65. Swan H, Toivonen L, Viitasalo M (1998) Rate adaptation of QT intervals during and after exercise in children with congenital long QT syndrome. Eur Heart J 19:508–513

    Article  PubMed  CAS  Google Scholar 

  66. Schwartz PJ, Priori SG, Locati EH et al (1995) Long QT syndrome patients with mutations of the SCN5A and HERG genes have differential responses to Na+ channel blockade and to increases in heart rate. Implications for gene-specific therapy. Circulation 92:3381–3386

    Article  PubMed  CAS  Google Scholar 

  67. Ackerman MJ, Khositseth A, Tester DJ, Hejlik J, Shen WK, Porter CJ (2002) Epinephrine-induced QT interval prolongation: a gene-specific paradoxical response in congenital long QT syndrome. Mayo Clin Proc 77:413–421

    Google Scholar 

  68. ShimizuW, Noda T, Takaki H et al (2003) Epinephrine unmasks latent mutation carriers with LQT1 form of congenital long-QT syndrome. J Am College Cardiol 41:633–642

    Article  CAS  Google Scholar 

  69. Vyas H, Hejlik J, Ackerman MJ (2006) Epinephrine QT stress testing in the evaluation of congenital long-QT syndrome: diagnostic accuracy of the paradoxical QT response. Circulation 113:1385–1392

    Article  PubMed  CAS  Google Scholar 

  70. TesterDJ, Will ML, Haglund CM et al (2005) Compendium of cardiac channel mutations in 541 consecutive unrelated patients referred for long QT syndrome genetic testing. Heart Rhythm 2:507–517

    Article  Google Scholar 

  71. Napolitano C, Priori SG, Schwartz PJ et al (2005) Genetic testing in the long QT syndrome: development and validation of an efficient approach to genotyping in clinical practice [see comment]. JAMA 294:2975–2980

    Article  PubMed  CAS  Google Scholar 

  72. Tester DJ, Will ML, Haglund CM et al (2006) Effect of clinical phenotype on yield of long QT syndrome genetic testing. J Am College Cardiol 47:764–768

    Article  Google Scholar 

  73. Westenskow P, Splawski I, Timothy KW et al (2004) Compound mutations: a common cause of severe long-QT syndrome. Circulation 109:1834–1841

    Article  PubMed  Google Scholar 

  74. Ackerman MJ, Splawski I, Makielski JC et al (2004) Spectrum and prevalence of cardiac sodium channel variants among black, white, Asian, and Hispanic individuals: implications for arrhythmogenic susceptibility and Brugada/long QT syndrome genetic testing. Heart Rhythm 1:600–607

    Article  PubMed  Google Scholar 

  75. Ackerman MJ, Tester DJ, Jones GS et al (2003) Ethnic differences in cardiac potassium channel variants: implications for genetic susceptibility to sudden cardiac death and genetic testing for congenital long QT syndrome. Mayo Clin Proc 78:1479–1487

    Article  PubMed  CAS  Google Scholar 

  76. Kapa S, Tester DJ, Salisbury BA et al (2009) Genetic testing for long QT syndrome: distinuishing pathogenic mutations from benign variants. Circulation 120:1752–1760

    Article  PubMed  CAS  Google Scholar 

  77. Moss AJ, Zareba W, Hall WJ et al (2000) Effectiveness and limitations of beta-blocker therapy in congenital long-QT syndrome. Circulation 101:616–623

    Article  PubMed  CAS  Google Scholar 

  78. Priori SG, Schwartz PJ, Napolitano C et al (2003) Risk stratification in the long-QT syndrome. N Engl J Med 348: 1866–1874

    Article  PubMed  Google Scholar 

  79. Priori SG, Aliot E, Blomstrom-Lundqvist C et al (2001) Task force on sudden cardiac death of the European society of cardiology. Eur Heart J 22:1374–1450

    Article  PubMed  CAS  Google Scholar 

  80. Locati EH, Zareba W, Moss AJ et al (1998) Age- and sex-related differences in clinical manifestations in patients with congenital long-QT syndrome: findings from the international LQTS registry. Circulation 97:2237–2244

    Article  PubMed  CAS  Google Scholar 

  81. Priori SG, Schwartz PJ, Napolitano C et al (2003) Risk stratification in the long-QT syndrome. N Engl J Med 348: 1866–1874

    Article  PubMed  Google Scholar 

  82. Moss AJ, Shimizu W, Wilde AA et al (2007) Clinical aspects of type-1 long-QT syndrome by location, coding type, and biophysical function of mutations involving the KCNQ1 gene. Circulation 115:2481–2489

    Article  PubMed  CAS  Google Scholar 

  83. Zareba W, Moss AJ, Schwartz PJ et al (1998) Influence of genotype on the clinical course of the long-QT syndrome. International long-QT syndrome registry research group. N Engl J Med 339:960–965

    Article  PubMed  CAS  Google Scholar 

  84. Kaufman ES, McNitt S, Moss AJ et al (2008) Risk of death in the long QT syndrome when a sibling has died. Heart Rhythm 5:831–836

    Article  PubMed  Google Scholar 

  85. Malfatto G, Beria G, Sala S et al (1994) Quantitative analysis of T wave abnormalities and their prognostic implications in the idiopathic long QT syndrome. J Am Coll Cardiol 23:296–301

    Article  PubMed  CAS  Google Scholar 

  86. Bhandari AK, Shapiro WA, Morady F et al (1985) Electrophysiologic testing in patients with the long QT syndrome. Circulation 71:63–71

    Article  PubMed  CAS  Google Scholar 

  87. Garson A Jr, Dick M 2nd, Fournier A et al (1993) The long QT syndrome in children. An international study of 287 patients. Circulation 87:1866–1872

    Article  PubMed  Google Scholar 

  88. Priori SG, Maugeri FS, Schwartz PJ (1998) The risk of sudden death as first cardiac event in asymptomatic patients with the long QT syndrome (abstract). Circulation 98(Suppl I):777

    Google Scholar 

  89. Ackerman MJ (1998) The long QT syndrome: ion channel diseases of the heart. Mayo Clin Proc 73:250–269

    Article  PubMed  CAS  Google Scholar 

  90. Schwartz PJ (1997) The long QT syndrome. Curr Probl Cardiol 22:297–351

    Article  PubMed  CAS  Google Scholar 

  91. Chatrath R, Bell CM, Ackerman MJ (2004) Beta-blocker therapy failures in symptomatic probands with genotyped long-QT syndrome. Pediatr Cardiol 25:459–465

    Article  PubMed  CAS  Google Scholar 

  92. Viskin S, Fish R, Zeltser D et al (2000) Arrhythmias in the congenital long QT syndrome: how often is torsade de pointes pause dependent? Heart 83:661–666

    Article  PubMed  CAS  Google Scholar 

  93. Dorostkar PC, Eldar M, Belhassen B et al (1999) Long-term follow-up of patients with long-QT syndrome treated with beta-blockers and continuous pacing. Circulation 100:2431–2436

    Article  PubMed  CAS  Google Scholar 

  94. Viskin S (2000) Cardiac pacing in the long QT syndrome: review of available data and practical recommendations. J Cardiovasc Electrophysiol 11:593–600

    Article  PubMed  CAS  Google Scholar 

  95. Chatrath R, Porter CJ, Ackerman MJ (2002) Role of transvenous implantable cardioverter-defibrillators in preventing sudden cardiac death in children, adolescents, and young adults. Mayo Clin Proc 77:226–231

    Article  PubMed  Google Scholar 

  96. Zareba W, Moss AJ, Daubert JP et al (2003) Implantable cardioverter defibrillator in high-risk long QT syndrome patients. J Cardiovasc Electrophysiol 14:337–341

    Article  PubMed  Google Scholar 

  97. Monnig G, Kobe J, Loher A et al (2005) Implantable cardioverter-defibrillator therapy in patients with congenital long-QT syndrome: a long-term follow-up. Heart Rhythm 2:497–504

    Article  PubMed  Google Scholar 

  98. Moss AJ, Zareba W, Hall WJ et al (2000) Effectiveness and limitations of beta-blocker therapy in congenital long-QT syndrome. Circulation 101:616–623

    Article  PubMed  CAS  Google Scholar 

  99. Villain E, Denjoy I, Lupoglazoff JM et al (2004) Low incidence of cardiac events with B-blocking therapy in children with long QT syndrome. Eur Heart J 25:1405–1411

    Article  PubMed  CAS  Google Scholar 

  100. Schwartz PJ, Spazzolini C, Crotti L et al (2006) The Jervell and Lange-Nielsen syndrome: natural history, molecular basis, and clinical outcome. Circulation 113:783–790

    Article  PubMed  Google Scholar 

  101. Shimizu W, Antzelevitch C (2000) Differential effects of beta-adrenergic agonists and antagonists in LQT1, LQT2 and LQT3 models of the long QT syndrome. J Am Coll Cardiol 35:778–786

    Article  PubMed  CAS  Google Scholar 

  102. Schwartz PJ, Spazzolini C, Crotti L (2009) All LQT3 patients need an ICD: true or false? Heart Rhythm 6:113–120

    Article  PubMed  Google Scholar 

  103. Moss AJ, McDonald J (1971) Unilateral cervicothoracic sympathetic ganglionectomy for the treatment of long QT interval syndrome. N Engl J Med 285:903–904

    Article  PubMed  CAS  Google Scholar 

  104. Collura CA, Johnson JN, Moir C et al (2009) Left cardiac sympathetic denervation for the treatment of long QT syndrome and catecholaminergic polymorphic ventricular tachycardia using video-assisted thoracic surgery. Heart Rhythm 6:752–759

    Article  PubMed  Google Scholar 

  105. Schwartz PJ, Priori SG, Cerrone M et al (2004) Left cardiac sympathetic denervation in the management of high-risk patients affected by the long-QT syndrome. Circulation 109:1826–1833

    Article  PubMed  Google Scholar 

  106. Moss AJ, McDonald J (1971) Unilateral cervicothoracic sympathetic ganglionectomy for the treatment of long QT interval syndrome. N Engl J Med 285:903–904

    Article  PubMed  CAS  Google Scholar 

  107. Schwartz PJ, Locati E (1985) The idiopathic long QT syndrome: pathogenetic mechanisms and therapy. Eur Heart J 6(Suppl D):103–114

    Article  PubMed  Google Scholar 

  108. Schwartz PJ, Priori SG, Cerrone M et al (2004) Left cardiac sympathetic denervation in the management of high-risk patients affected by the long-QT syndrome. Circulation 109:1826–1833

    Article  PubMed  Google Scholar 

  109. Schwartz PJ (2006) The congenital long QT syndromes from genotype to phenotype: clinical implications. J Inter Med 259:39–47

    Article  CAS  Google Scholar 

  110. Etheridge SP, Compton SJ, Tristani-Firouzi M et al (2003) A new oral therapy for long QT syndrome: long-term oral potassium improves repolarization in patients with HERG mutations. J Am Coll Cardiol 42:1777–1782

    Article  PubMed  CAS  Google Scholar 

  111. Bankston JR, Kass RS (2009) Molecular determinants of local anesthetic action of beta-blocking drugs: implications for therapeutic management of long QT syndrome variant 3. J Mol Cell Cardiol 48:246–253

    Google Scholar 

  112. Schwartz PJ, Priori SG, Locati EH et al (1995) Long QT syndrome patients with mutations of the SCN5A and HERG genes have differential responses to Na+ channel blockade and to increases in heart rate. Implications for gene-specific therapy. Circulation 92:3381–3386

    Article  PubMed  CAS  Google Scholar 

  113. Shimizu W, Antzelevitch C (1997) Sodium channel block with mexiletine is effective in reducing dispersion of repolarization and preventing torsade des pointes in LQT2 and LQT3 models of the long-QT syndrome. Circulation 96: 2038–2047

    Article  PubMed  CAS  Google Scholar 

  114. Fitzgerald PT, Ackerman MJ (2005) Drug-induced torsades de pointes: the evolving role of pharmacogenetics. Heart Rhythm 2:S30–S37

    Article  PubMed  Google Scholar 

  115. Vyas H, Johnson K, Houlihan R et al (2006) Acquired long QT syndrome secondary to cesium chloride supplement. Altern Complement Med 12:1011–1014

    Google Scholar 

  116. Moss AJ, Robinson JL, Gessman L et al (1999) Comparison of clinical and genetic variables of cardiac events associated with loud noise versus swimming among subjects with the long QT syndrome. Am J Cardiol 84:876–879

    Article  PubMed  CAS  Google Scholar 

  117. Schwartz PJ, Priori SG, Spazzolini C et al (2001) Genotype-phenotype correlation in the long-QT syndrome: gene-specific triggers for life-threatening arrhythmias. Circulation 103:89–95

    Article  PubMed  CAS  Google Scholar 

  118. Caldwell G, Millar G, Quinn E et al (1985) Simple mechanical methods for cardioversion: defence of the precordial thump and cough version. Br Med J (Clin Res Ed) 291:627–630

    Article  CAS  Google Scholar 

  119. Zipes DP, Ackerman MJ, Estes NA 3rd et al (2005) Task Force 7: arrhythmias. J Am Coll Cardiol 45:1354–1363

    Article  PubMed  Google Scholar 

  120. Heidbuchel H, Corrado D, Biffi A et al (2006) Recommendations for participation in leisure-time physical activity and competitive sports of patients with arrhythmias and potentially arrhythmogenic conditions. Part II: ventricular arrhythmias, channelopathies and implantable defibrillators. Eur J Cardiovasc Prev Rehabil 13:676–686

    Article  PubMed  Google Scholar 

  121. Ackerman et al (2008) Congenital long QT syndrome. In Electrical diseases of the heart; genetics, mechanisms, treatment, prevention. Springer, New York, NY, pp 462–482

    Google Scholar 

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Johnson, J.N., Ackerman, M.J. (2011). Long QT Syndrome. In: Yan, GX., Kowey, P. (eds) Management of Cardiac Arrhythmias. Contemporary Cardiology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-60761-161-5_19

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