Treatment of Acquired Long QT Syndrome in Patients with a History of Sudden Cardiac Arrest

Among patients with acquired long QT syndrome, those who have survived a cardiac arrest carry the highest risk of recurrent life-threatening arrhythmia. This clinical scenario — LQTS with aborted cardiac arrest — requires a specific, protocol-driven management approach distinct from lower-risk presentations.

Clinical scenario

Long QT syndrome with aborted cardiac arrest: the patient is a cardiac arrest survivor. This history of sudden cardiac arrest places the patient in the highest-risk tier for recurrent events, and the management strategy is calibrated accordingly.

Treatment approach — partial overview

The recommended approach for this scenario involves a combination of a device-based intervention together with pharmacological therapy, alongside a set of general protective measures aimed at minimising further arrhythmic risk. Full agent selection, sequencing, and all specific recommendations are available in the complete protocol.

Full regimen, criteria, and clinical algorithm available below →
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References

DOI: 10.1093/eurheartj/ehac262

ICD implantation in addition to beta-blockers is recommended in LQTS patients with CA.

Beta-blockers, ideally non-selective beta-blockers (nadolol or propranolol), are recommended in LQTS patients with documented QT interval prolongation, to reduce risk of arrhythmic events.

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