T-Wave Morphology Analysis to Detect High Risk in Long-QT Syndrome
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See Article by Sugrue et al
One of the most important gaps in knowledge in the management of patients with congenital long-QT syndrome (LQTS) is our poor ability to detect patients who will remain at risk of a cardiac event even after standard therapy has been initiated. The majority of LQTS patients will achieve adequate risk reduction with antiadrenergic (usually β-blocker) therapy and should not be subjected to the risks and complications of an implantable defibrillator. However, a small subset of patients will have a residual risk of life-threatening ventricular arrhythmia.
Very-high-risk patients can be easy to spot, especially if they have had an aborted cardiac arrest, or a very long QT interval and history of arrhythmic syncope. Conversely, patients with mild- to moderate-QT prolongation and no history of syncope rarely develop symptoms of syncope or cardiac arrest on β-blocker therapy. However, there are some patients who are more difficult to sort out. Among these are patients with variable but sometimes marked QT prolongation, patients with unexplained symptoms, …