Recent findings
LQT syndrome remains
the most common inherited arrhythmia and is a leading cause for
sudden unexplained death accounting for up to 20–25% of cases.
Rapid progress of genetic technology over the past 2 decades has
significantly improved our understanding of molecular and genetic
mechanisms of LQT. Despite all those novel insights, phenotype
assessment and appropriate risk stratification in LQT remains
challenging – even for the expert.
Summary
This review outlines
our current understanding and approach to the clinical diagnosis and
management of LQT as well as recent insights into genotype–phenotype
correlations. Genetic testing has evolved beyond a pure diagnostic
tool and is in addition increasingly integrated as complementary
prognostic marker. With regard to the management of LQT, there is now
evidence that the protective effect of beta-blockers is rather
substance-specific than a class effect. Novel approaches – in
conjunction with standard beta-blockers – are emerging including
gene-specific treatment for certain subtypes of LQT. A specialized
inherited arrhythmia clinic is the preferred resource for the complex
risk stratification and individualized management of individuals with
LQT.
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