Hostname: page-component-cd9895bd7-dzt6s Total loading time: 0 Render date: 2024-12-24T13:21:12.527Z Has data issue: false hasContentIssue false
  • English
  • Français

Sports participation in long QT syndrome

Published online by Cambridge University Press:  13 January 2017

Peter F. Aziz  and
Elizabeth V. Saarel
Peter F. Aziz*
Affiliation:
Department of Pediatric Cardiology, Cleveland Clinic Main Campus, Cleveland, Ohio, United States of America
Elizabeth V. Saarel
Affiliation:
Department of Pediatric Cardiology, Cleveland Clinic Main Campus, Cleveland, Ohio, United States of America
*
Correspondence to: P. F. Aziz MD, Department of Pediatric Cardiology, Cleveland Clinic Main Campus, Mail Code M41, 9500 Euclid Avenue, Cleveland, OH 44195, United States of America. Tel: +216 445 6532; Fax: +216 445 3692; E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Untreated congenital long QT syndrome may result in potentially lethal ventricular tachycardia. In the most common type, risk of such an event has been linked to exercise. This originally resulted in very restrictive guidelines for sports participation in affected individuals. Although the complex interactions of a specific genotype, modifying cofactors, and risk are only now being explored, scientific evidence based on clinical experience now suggests that in many instances such restrictive guidelines are unwarranted. In particular, patients with this condition who are compliant with β-blocker therapy and who have never had symptoms during exertion are now enjoying the benefits of athletic activity.

Keywords

Long QT syndromesudden deathathletesports participation
Type
Original Articles
Information
Cardiology in the Young , Volume 27 , Supplement S1: Sudden Cardiac Arrest in the Young: A Contemporary Perspective , January 2017 , pp. S43 - S48
Copyright
© Cambridge University Press 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Jervell, A, Lange-Nielsen, F. Congenital deaf-mutism, functional heart disease with prolongation of the Q-T interval and sudden death. Am Heart J 1957; 54: 59–68.Google Scholar
2. Ward, OC. A new familial cardiac syndrome in children. J Ir Med Assoc 1964; 54: 103–106.Google Scholar
3. Schwartz, PJ, Stramba-Badiale, M, Crotti, L, et al. Prevalence of the congenital long-QT syndrome. Circulation 2009; 120: 1761–1767.Google Scholar
4. Tester, DJ, Will, ML, Haglund, CM, et al. Effect of clinical phenotype on yield of long QT syndrome genetic testing. J Am Coll Cardiol 2006; 47: 764–768.Google Scholar
5. Schwartz, PJ, Crotti, L. QTc behavior during exercise and genetic testing for the long-QT syndrome. Circulation 2011; 124: 2181–2184.Google Scholar
6. Ackerman, MJ. Cardiac channelopathies: it’s in the genes. Nat Med 2004; 10: 463–464.Google Scholar
7. Liu, JF, Jons, C, Moss, AJ, et al. Risk factors for recurrent syncope and subsequent fatal or near-fatal events in children and adolescents with long QT syndrome. J Am Coll Cardiol 2011; 57: 941–950.Google Scholar
8. Antzelevitch, C, Shimizu, W. Cellular mechanisms underlying the long QT syndrome. Curr Opin Cardiol 2002; 17: 43–51.Google Scholar
9. Keating, MT, Sanguinetti, MC. Molecular and cellular mechanisms of cardiac arrhythmias. Cell 2001; 104: 569–580.Google Scholar
10. Jost, N, Viraq, L, Bitay, M, et al. Restricting excessive cardiac action potential and QT prolongation: a vital role for IKs in human ventricular muscle. Circulation 2005; 112: 1392–1399.Google Scholar
11. Tseng, GN, Xu, Y. Understanding the microscopic mechanisms for LQT1 needs a global view of the I(Ks) channel. Heart Rhythm 2015; 12: 395–396.Google Scholar
12. Schwartz, PJ, Priori, SG, Spazzolini, C, et al. Genotype-phenotype correlation in the long-QT syndrome: gene-specific triggers for life-threatening arrhythmias. Circulation 2001; 103: 89–95.Google Scholar
13. Aziz, PF, Wieand, TS, Ganley, J, et al. Genotype- and mutation site-specific QT adaptation during exercise, recovery, and postural changes in children with long-QT syndrome. Circ Arrhythm Electrophysiol 2011; 4: 867–873.Google Scholar
14. Zareba, W, Moss, AJ, Schwartz, PJ, et al. Influence of genotype on the clinical course of the long-QT syndrome. International long-QT syndrome registry research group. N Engl J Med 1998; 339: 960–965.Google Scholar
15. Priori, SG, Schwartz, PJ, Napolitano, C, et al. Risk stratification in the long-QT syndrome. N Engl J Med 2003; 348: 1866–1874.Google Scholar
16. Goldenberg, I, Moss, AJ, Peterson, DR, et al. Risk factors for aborted cardiac arrest and sudden cardiac death in children with the congenital long-QT syndrome. Circulation 2008; 117: 218421–218491.Google Scholar
17. Hobbs, JB, Peterson, DR, Moss, AJ, et al. Risk of aborted cardiac arrest or sudden cardiac death during adolescence in the long-QT syndrome. JAMA 2006; 296: 1249–1254.Google Scholar
18. Malloy, KJ, Bahinski, A. Cardiovascular disease and arrhythmias: unique risks in women. J Gend Specif Med 1999; 2: 37–44.Google Scholar
19. Goldenberg, I, Horr, S, Moss, AJ, et al. Risk for life-threatening cardiac events in patients with genotype-confirmed long-QT syndrome and normal-range corrected QT intervals. J Am Coll Cardiol 2011; 57: 51–59.Google Scholar
20. Villain, E, Denjoy, I, Lupoglazoff, JM, et al. Low incidence of Cardiac events with beta-blocking therapy in children with long QT syndrome. Eur Heart J 2004; 25: 1405–1411.Google Scholar
21. Vincent, GM, Schwartz, PJ, Denjoy, I, et al. High efficacy of beta-blockers in long-QT syndrome type 1: contribution of noncompliance and QT-prolonging drugs to the occurrence of beta-blocker treatment “failures”. Circulation 2009; 119: 215–221.Google Scholar
22. Mitchell, JH, Haskell, W, Snell, P, Van Camp, SP. Task Force 8: classification of sports. J Am Coll Cardiol 2005; 45: 1364–1367.Google Scholar
23. Pelliccia, A, Zipes, DP, Maron, BJ. Bethesda conference #36 and the European Society of Cardiology Consensus Recommendations revisited a comparison of U.S. and European criteria for eligibility and disqualification of competitive athletes with cardiovascular abnormalities. J Am Coll Cardiol 2008; 52: 1990–1996.Google Scholar
24. Pelliccia, A, Fagard, R, Bjornstad, HH, et al. Recommendations for competitive sports participation in athletes with cardiovascular disease: a consensus document from the Study Group of Sports Cardiology of the Working Group of Cardiac Rehabilitation and Exercise Physiology and the Working Group of Myocardial and Pericardial Diseases of the European Society of Cardiology. Eur Heart J 2005; 26: 1422–1445.Google Scholar
25. Aziz, PF, Sweeten, T, Vogel, RL, et al. Sports participation in genotype positive children with long QT syndrome. JACC Clin Electrophysiol 2015; 1: 62–70.Google Scholar
26. Priori, SG, Wilde, AA, Horie, M, et al. HRS/EHRA/APHRS expert consensus statement on the diagnosis and management of patients with inherited primary arrhythmia syndromes: document endorsed by HRS, EHRA, and APHRS in May 2013 and by ACCF, AHA, PACES, and AEPC in June 2013. Heart Rhythm 2013; 10: 1932–1963.Google Scholar
27. Asif, IM, Price, DE, Ewing, A, Rao, AL, Harmon, KG, Drezner, JA. The impact of diagnosis: measuring the psychological response to being diagnosed with serious or potentially lethal cardiac disease in young competitive athletes. Br J Sports Med 2016; 50: 163–166.Google Scholar
28. Ackerman, MJ, Zipes, DP, Kovacs, RJ, Maron, BJ. Eligibility and disqualification recommendations for competitive athletes with cardiovascular abnormalities: Task Force 10: the cardiac channelopathies: a scientific statement from the American Heart Association and American College of Cardiology. J Am Coll Cardiol 2015; 66: 2424–2428.Google Scholar