Apr 29, 2015
Rethinking Long QT Restrictions

A pediatric cardiologist who led a study of children with long QT syndrome (LQTS) says it may be time to consider allowing them to play a wider range of sports than suggested under current guidelines.

Medical News Today reports that since 2005, it’s been recommended people with LQTS be limited to participation in only six sports due to the risk of cardiac arrhythmias: billiards, bowling, cricket, curling, golf, and riflery. Previously, it was advised that children with LQTS not play sports at all.

Peter Aziz, M.D., a pediatric cardiologist at Cleveland Clinic Children’s in Cleveland led a study that found none of 103 children being treated for LQTS suffered symptoms during sports participation. The study appeared in the debut issue of JACC: Clinical Electrophysiology in March.

 “Re-examining participation rules is important because the physiologic benefits of exercise at all ages have been emphasized repeatedly and promoted as a national public health priority,” Aziz said. “The enhanced self-confidence, sense of psychological, physical and social well-being, and improved overall quality of life that sports participation brings to children and adolescents is equally important.”

Aziz told the Cleveland Clinic’s ConsultQD, that that limiting or avoiding activity is not the only way to minimize the risk for children with LQTS. Other methods include:

• Taking a beta blocker regularly

• Communicating openly with doctors

• Having access to an automated external defibrillator—preferably a personal one—for patients who do not have an implantable cardioverter defibrillator

In a separate editorial in the journal, Michael J. Ackerman, M.D., Ph.D., Professor of Medicine, Pediatrics and Pharmacology and Director of the Long QT Syndrome Clinic at Mayo Clinic, said allowing children with LQTS to play sports comes down to making a well-informed decision.

“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.”


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