Long QT Syndrome natural history, complications and prognosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [2]
Overview
Natural History
About half the patients will have an arrhythmia that degenerates into Torsade de Pointes.
Complications
Long QT syndrome can result in fatal heart arrhythmias and death. Certain medications can increase the risk of fatal arrhythmias and death in persons with long QT syndrome.
List of Medications to be Avoided in Congenital Long QT Syndrome
- Albuterol
- Alfuzosin
- Amantadine
- Amiodarone
- Amisulpride
- Amitriptyline
- Amphetamine
- Arsenic trioxide
- Artenimol + piperaquine
- Astemizole
- Atazanavir
- Atomoxetine
- Azithromycin
- Bepridil
- Chloral hydrate
- Chloroquine
- Chlorpromazine
- Ciprofloxacin
- Cisapride
- Citalopram
- Clarithromycin
- Clomipramine
- Clozapine
- Cocaine
- Desipramine
- Dexmethylphenidate
- Diphenhydramine
- Diphenhydramine
- Disopyramide
- Dobutamine
- Dofetilide
- Dolasetron
- Domperidone
- Dopamine
- Doxepin
- Dronedarone
- Droperidol
- Ephedrine
- Epinephrine
- Eribulin
- Erythromycin
- Escitalopram
- Famotidine
- Fenfluramine
- Fingolimod
- Flecainide
- Fluconazole
- Fluoxetine
- Foscarnet
- Fosphenytoin
- Galantamine
- Gatifloxacin
- Gemifloxacin
- Granisetron
- Halofantrine
- Haloperidol
- Ibutilide
- Iloperidone
- Imipramine
- Indapamide
- Isoproterenol
- Isradipine
- Itraconazole
- Ketoconazole
- Lapatinib
- Levalbuterol
- Levofloxacin
- Levomethadyl
- Lisdexamfetamine
- Lithium
- Mesoridazine
- Metaproterenol
Methadone
Methadone
Methylphenidate
Methylphenidate
Midodrine
Mirtazapine
Moexipril/HCTZ
Moxifloxacin
Nicardipine
Nilotinib
Norepinephrine
Nortriptyline
Octreotide
Ofloxacin
Ondansetron
Oxytocin
Paliperidone
Paroxetine
Pentamidine
Pentamidine
Perflutren lipid microspheres
Phentermine
Phentermine
Phenylephrine
Phenylpropanolamine
Phenylpropanolamine
Pimozide
Probucol
Procainamide
Procainamide
Protriptyline
Pseudoephedrine
Pseudoephedrine
Quetiapine
Quinidine
Quinidine
Ranolazine
Risperidone
Ritodrine
Ritonavir
Roxithromycin*
Salmeterol
Sertindole
Sertindole
Sertraline
Sevoflurane
Sibutramine
Solifenacin
Sotalol
Sparfloxacin
Sunitinib
Tacrolimus
Tamoxifen
Telithromycin
Terbutaline
Terfenadine
Thioridazine
Tizanidine
Tolterodine
Trazodone
Trimethoprim-Sulfa
Trimipramine
Vandetanib
Vardenafil
Venlafaxine
Voriconazole
Ziprasidone
Prognosis
People who are treated with lifestyle modifications and medications live longer than those who are not. For people who are not treated, half of them, mostly those with the inherited form of long QT syndrome, will die within 10 years.
The Jervell and Lange-Nielsen syndrome (JLNS) is an autosomal recessive form of LQTS with associated congenital deafness. It is caused specifically by mutation of the KCNE1 and KCNQ1 genes. In untreated individuals with JLNS, about 50 percent die by the age of 15 years due to ventricular arrhythmias.