American-Style Football Player with Asymptomatic Long QT Syndrome
A 17-year-old male African-American American-style football player was found to have the following screening electrocardiogram (ECG, Figure 1) during pre-participation cardiovascular screening. He had no known medical history and no known family history of sudden cardiac death or inherited cardiovascular disease. He did not take any medications and denied any exertional chest pain, palpitations, shortness of breath, lightheadedness, seizures or syncope. The physical examination was unremarkable. With this ECG, he proceeded with an exercise treadmill test, which did not elicit any ventricular arrhythmias, but the QTc interval persisted at 556ms 2 minutes into the recovery period. Further genetic testing revealed a mutation in the KCNH2 gene affirming the diagnosis of congenital Long QT Type 2.
What is the next best step in management?