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Sports_Channel_LQTS_Overview.html
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<!DOCTYPE html>
<html lang="en">
<!-- defines the default zoom for mobile devices -->
<meta name="viewport" content="width=device-width, initial-scale=1" />
<head>
<meta charset="UTF-8">
<title>CardioRef: AHA/ACC 2015 Sports Participation Selector Guide: Channelopathies: Long QT Syndrome</title>
<link rel="stylesheet" href="css/sports_answer_combined.css">
<style>
div{
-webkit-margin-before:0;
-webkit-margin-after:0;
-webkit-margin-start:0;
-webkit-margin-end:0;
}
</style>
</head>
<body>
<div class="topbar">
<a href="index.html">Pedi CardioRef</a>
<div class="guidelinebar">
<a target="_blank" rel="noopener noreferrer" href="https://www.ahajournals.org/doi/10.1161/CIR.0000000000000246">
Reference: ACC/AHA Sports Participation Recommendations (Circulation 2015) Task Force 10: The Cardiac Channelopathies</a>
</div>
</div>
<section style="margin:10px">
<p class="topspace"></p>
<label><b>By the ACC/AHA 2015 guidelines, should my patient with</label>
<select name="disease" id="dz" class="InputBox" onChange="goThere();">
<option value="">*Select Disease*</option>
<option value ="" class="dropdown-divider">---------------------------------------------------------------</option>
<option value="HCM">Hypertrophic Cardiomyopathy </option>
<option value="LVNC">Left Ventricular Non-Compaction </option>
<option value="DilRestr">Dilated or Restrictive Cardiomyopathy </option>
<option value="ARVC">Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC) </option>
<option value="Myo">Myocarditis </option>
<option value="Peri">Pericarditis </option>
<option value ="" class="dropdown-divider">---------------------------------------------------------------</option>
<option value="ASDVSDPDA">ASD, VSD, or PDA </option>
<option value="PS">Pulmonic Stenosis </option>
<option value="AS">Aortic Stenosis </option>
<option value="Coarct">Coarctation </option>
<option value="Cyan">Cyanotic Heart Disease, unrepaired or with palliative shunt </option>
<option value="TOF">Tetralogy of Fallot, s/p repair </option>
<option value="TGA_Must">d-transposition (d-TGA), s/p atrial switch (Mustard/Senning)</option>
<option value="TGA_Art">d-transposition (d-TGA), s/p arterial switch </option>
<option value="CCTGA">Congenitally-corrected TGA (CC-TGA, L-TGA)</option>
<option value="Fontan">Fontan </option>
<option value="Ebstein">Ebstein Anomaly </option>
<option value="AnomCoronary">Anomalous Coronary Artery Origin</option>
<option value ="" class="dropdown-divider">---------------------------------------------------------------</option>
<option value="PVR">Elevated PVR in CHD </option>
<option value="VentricularDysfxn">Ventricular Dysfunction s/p CHD Surgery</option>
<option value ="" class="dropdown-divider">---------------------------------------------------------------</option>
<option value="Valve_AS">Aortic Stenosis</option>
<option value="Valve_AR">Aortic Regurgitation </option>
<option value="Valve_MS">Mitral Stenosis</option>
<option value="Valve_MR">Mitral Regurgitation </option>
<option value="Valve_Hx">History of Mitral or Aortic Valve Surgery</option>
<option value ="" class="dropdown-divider">---------------------------------------------------------------</option>
<option value="HTN">Hypertension </option>
<option value ="" class="dropdown-divider">---------------------------------------------------------------</option>
<option value="AoDiseases_and_Marfan">Aortic Diseases and Marfan Syndrome</option>
<option value="BAV">Bicuspid Aortic Valve</option>
<option value="Marfan">Marfan Syndrome</option>
<option value="TAA">Thoracic Aortic Aneurysm, familial or unexplained</option>
<option value="LoeysDietz_EhlersDanlos">Loeys-Dietz or vascular Ehlers-Danlos</option>
<option value="AoEnlarge">Enlarged Aorta, non-syndrome non-familial</option>
<option value="Ao_Surgery">S/p Surgery for Aortic Enlargement/Dissection</option>
<option value="Chronic_AoDissection">Chronic Aortic Dissection or Branch Aneurysm</option>
<option value ="" class="dropdown-divider">---------------------------------------------------------------</option>
<option value="CoronaryOverview">Coronary Artery Disease </option>
<option value ="" class="dropdown-divider">---------------------------------------------------------------</option>
<option value="Syncope">Syncope </option>
<option value="Arrhythmia">Arrhythmias (SVT, PVC, Vtach, etc.) </option>
<option value="ConductionDefect">Conduction Defects (AV block, brady, pacemaker, RBBB/LBBB)</option>
<option value="Channelopathies">Channelopathies (LQTS, CPVT, Brugada, etc.) </option>
<option value="ICD">Implantable Cardioverter-Defibrillator (ICD) </option>
</select>
<span>participate in organized sports?</span></b>
<br><br>
<section id="question">
Should my patient with <b>Long QT Syndrome (LQTS)</b> participate in organized sports?
</section>
</section>
<!-- End of 10px margin section. Consider changing template. -->
<br>
<!-- navigation bar for disease sub-categories -->
<nav>
<a href="Sports_Channel_LQTS_Overview.html" class="active">Long QT Syndrome (LQTS)</a>
<a href="Sports_Channel_SQTS_Overview.html">Short QT Syndrome (SQTS)</a>
<a href="Sports_Channel_CPVT_Overview.html">Catecholaminergic Polymorphic Ventricular Tachycardia (CPVT)</a>
<a href="Sports_Channel_EarlyRepol_Overview.html">Early Repolarization</a>
<a href="Sports_Channel_BrS_Overview.html">Brugada Syndrome (BrS)</a>
<a href="Sports_Channel_IVT_Overview.html">Idiopathic Ventricular Tachycardia</a>
</nav>
<div class="largeanswerbox">
<h2 align=center>Long QT Syndrome (LQTS)</h2>
<hr>
<h3 align=center>General Recommendations:</h3>
<section class="single_center">
<p class="sectiontitle">All patients with suspected channelopathy</p>
<p>"For athletes with a suspected/diagnosed cardiac channelopathy, a comprehensive evaluation by a heart rhythm specialist
or genetic cardiologist with sufficient experience and expertise with these disorders is recommended."
</p>
<div class="verdict_maybe"><b>Get evaluated by heart rhythm specialist or genetic cardiologist</b>j</div>
<p class="rec_class">(Class I Recommendation; Level of Evidence C)</p>
</section>
<p></p>
<section class="single_center">
<p class="sectiontitle">Sympatomatic with suspected/diagnosed channelopathy</p>
<p>"It is recommended that symptomatic athletes with any suspected or diagnosed cardiac channelopathy
be restricted from all competitive sports until a comprehensive evaluation has been completed,
the athlete and his or her family are well informed, a treatment program has been implemented,
and the athlete has been asymptomatic on therapy for 3 months."
</p>
<div class="verdict_no">No sports until comprehensive evaluation completed</div>
<p class="rec_class">(Class I Recommendation; Level of Evidence C)</p>
</section>
<p>
<hr width="80%">
</p>
<h3 align=center>LQTS-specific Recommendations:</h3>
<section id="needtoknow">
<p class="sectiontitle">Need to know:</p>
<ul>
<li>Ever sympatomatic?</li>
<li>Ever electrographically evident?</li>
</ul>
</section>
<!-- arrows -->
<section id="answer_arrow_section">
<section class="half_left_invisible"> <p class="arrowsdouble"> ⇙</p></section>
<section class="half_right_invisible"> <p class="arrowsdouble"> ⇘</p></section>
</section>
<!-- answer -->
<section id="answer">
<section class="half_left">
<p class="sectiontitle">Asymptomatic, Genotype + / Phenotype -</p>
<p>It is reasonable for an asymptomatic athlete with genotype-positive/phenotype-negative
(ie, concealed channelopathy) LQTS to participate in all
competitive sports with appropriate precautionary measures, including</p>
<ul>
<li><b>avoidance of QT-prolonging drugs</b> (http://www.crediblemeds.org)</li>
<li><b>electrolyte/hydration replenishment</b> and <b>avoidance of dehydration</b></li>
<li><b>avoidance or treatment of hyperthermia</b> from febrile illnesses or training-related heat exhaustion or heat stroke</li>
<li>acquisition of a personal <b>automatic external defibrillator</b> as part of the athlete’s personal sports safety gear</li>
<li>establishment of an <b>emergency action plan</b> with the appropriate school or team officials</li>
</ul>
</p>
<div class="verdict_ok"><b>All sports = reasonable</b> if the above precautionary measures are undertaken</div>
<p class="rec_class">(Class IIa Recommendation; Level of Evidence C)</p>
</section>
<section class="half_right">
<p class="sectiontitle">History of symptomatic LQTS or electrographically manifest LQTS</p>
<p>"For an athlete with either symptomatic LQTS or electrocardiographically manifest LQTS
(ie, corrected QT interval >470 ms in males or >480 ms in females),
competitive sports participation <i>(except competitive swimming in a previously symptomatic LQT1 host)</i>
may be considered <b>after institution of treatment and appropriate precautionary measures assuming
the athlete has been asymptomatic on treatment for at least 3 months</b>. </p>
<p>"If treatment includes an ICD, refer to the Task Force 9 report for recommendations
regarding restrictions after the procedure, lead replacements, and so forth."
</p>
<div class="verdict_maybe"><u>If</u> precautionary measures undertaken <u>and</u> asymptomatic on treatment x 3 months,
<b>may consider sports participation</b></div>
<br>
<div class="verdict_no">Exception: People with symptomatic LQT1 should <u>not</u> participate in competitive swimming</div>
<p class="rec_class">(Class IIb Recommendation; Level of Evidence C)</p>
</section>
</section>
</div>
<p class="foot">
<b>Reference:</b> <a href="https://www.ahajournals.org/doi/10.1161/CIR.0000000000000246"><i>Eligibility and Disqualification Recommendations for Competitive Athletes With Cardiovascular Abnormalities: Task Force 10: The Cardiac Channelopathies.</a>
A Scientific Statement From the AHA and ACC. Circulation 2015</i>
<br><br><b>Disclaimer:</b> This website is derived from published guidelines, but does not constitute medical advice
nor does it replace clinical judgement.
Only the text in quotation marks are direct quotations from the original guidelines.
Text not in quotations as well as the method of information display are all that of the
website creator and are not part of the original published guidelines.
Please consult a physician to discuss any patient-specific matters.
</p>
<section class="key">
<p><b>Key:</b>LQTS = long QT syndrome, ICD = implantable cardioverter defibrillator
</p>
</section>
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