Study Assesses Safety of Sports Participation in LQTS Patients

Participation in both competitive and recreational sports may be safer than previously thought for pediatric patients with congenital long QT syndrome (LQTS), according to results of a study published April 20 in the first issue of JACC: Clinical Electrophysiology.

In a retrospective cohort study, researchers reviewed data from 212 LQTS patients aged 4 – 21, referred to the Pediatric Arrhythmia Clinic at the Children’s Hospital in Philadelphia between 1998 and 2013, to evaluate the prevalence and outcomes of sports participation. Of those patients, 103 participated in competitive or recreational sports. The primary endpoint for the study was a serious adverse event during or up to two hours after sports. At the time of diagnosis of LQTS, 57 patients (55 percent) were asymptomatic, and all patients in this series were prescribed beta-blockade.

The retrospective review showed that there were no cardiac events and no deaths observed in treatment-compliant LQTS pediatric patients during their participation in sports. While patients with LQTS have typically been disqualified for sports, the authors of the study note that “it may be clinically beneficial to re-examine sports recommendations that were made based on data from an earlier era.”

In an accompanying editorial, Michael J. Ackerman, MD, PhD, FACC, professor of medicine, pediatrics and pharmacology and director of the Long QT Syndrome Clinic at Mayo Clinic in Rochester, MN, said decisions to play sports should be determined by a long QT syndrome expert in conjunction with the athlete and his or her family so that they can make a well-informed decision knowing all the risks.

“There must be a healthy dose of reverence and fear regarding the possibility of a long QT syndrome-triggered event, including the potential for a fatal one, to occur during sporting activities both competitive and recreational,” Ackerman said. “The question has never been whether aerobic activity for this group of patients is a potential risk but whether the risk can be minimized in other ways besides eliminating sports. We have concluded that the answer is yes.”

Clinical Topics: Arrhythmias and Clinical EP, Congenital Heart Disease and Pediatric Cardiology, Diabetes and Cardiometabolic Disease, Prevention, Sports and Exercise Cardiology, Implantable Devices, Genetic Arrhythmic Conditions, SCD/Ventricular Arrhythmias, Atrial Fibrillation/Supraventricular Arrhythmias, Congenital Heart Disease, CHD and Pediatrics and Arrhythmias, CHD and Pediatrics and Prevention, CHD and Pediatrics and Quality Improvement, Exercise, Sports and Exercise and Congenital Heart Disease and Pediatric Cardiology

Keywords: Athletes, Child, Cohort Studies, Electrophysiology, Exercise, Long QT Syndrome, Pediatrics, Philadelphia, Prevalence, Recreation, Research Personnel, Retrospective Studies, Sports

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