CardioRef: AHA/ACC 2015 Sports Participation Selector Guide: Channelopathies: Long QT Syndrome

Long QT Syndrome (LQTS)

General Recommendations:

All patients with suspected channelopathy

"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."

Get evaluated by heart rhythm specialist or genetic cardiologistj

(Class I Recommendation; Level of Evidence C)

Sympatomatic with suspected/diagnosed channelopathy

"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."

No sports until comprehensive evaluation completed

(Class I Recommendation; Level of Evidence C)

LQTS-specific Recommendations:

Need to know:

Ever sympatomatic?
Ever electrographically evident?

⇙

⇘

Asymptomatic, Genotype + / Phenotype -

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

avoidance of QT-prolonging drugs (http://www.crediblemeds.org)
electrolyte/hydration replenishment and avoidance of dehydration
avoidance or treatment of hyperthermia from febrile illnesses or training-related heat exhaustion or heat stroke
acquisition of a personal automatic external defibrillator as part of the athlete’s personal sports safety gear
establishment of an emergency action plan with the appropriate school or team officials

All sports = reasonable if the above precautionary measures are undertaken

(Class IIa Recommendation; Level of Evidence C)

History of symptomatic LQTS or electrographically manifest LQTS

"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 (except competitive swimming in a previously symptomatic LQT1 host) may be considered after institution of treatment and appropriate precautionary measures assuming the athlete has been asymptomatic on treatment for at least 3 months.

"If treatment includes an ICD, refer to the Task Force 9 report for recommendations regarding restrictions after the procedure, lead replacements, and so forth."

If precautionary measures undertaken and asymptomatic on treatment x 3 months, may consider sports participation

Exception: People with symptomatic LQT1 should not participate in competitive swimming

(Class IIb Recommendation; Level of Evidence C)

Reference: Eligibility and Disqualification Recommendations for Competitive Athletes With Cardiovascular Abnormalities: Task Force 10: The Cardiac Channelopathies. A Scientific Statement From the AHA and ACC. Circulation 2015

Disclaimer: 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.