Cardiac events related to sports participation were low among patients with long QT syndrome who continued to compete after being diagnosed with the condition in a recent study.
Researchers at the Mayo Clinic LQTS Clinic in Rochester, Minn., evaluated 353 patients aged 6 to 40 years with long QT syndrome (LQTS) between July 2000 and November 2010. During mean follow-up of 5.1 years, they determined that 196 patients were not involved in sports and 27 others discontinued competitive athletic participation after diagnosis. A competitive athlete was defined as playing organized sports at the little league, middle or high school, collegiate or professional level.
One hundred thirty patients (mean age, 11 years; 70 male) continued competitive play, including 20 with implantable cardioverter defibrillators (ICDs). From this group, 25% competed at a high school level, and 6% competed at a college, university or professional level.
“[Patients who choose to continue athletics] must be evaluated, risk-stratified, treated and counseled carefully so [they and their families] can make informed decisions,” Michael J. Ackerman, MD, PhD, pediatric cardiologist and director of Mayo’s LQTS Clinic, said in a press release.
During follow-up researchers learned that 70 of the LQTS athletes remained competitive in conflict with European Society of Cardiology (ESC) guidelines that prohibit participation based upon corrected QT intervals (QTc) of more than 440 milliseconds for males and more than 460 milliseconds for females. None reported a sports-related incident.
The other 60 LQTS patients opposed less stringent guidelines established by the 36th Bethesda Conference (no participation with QTc >470 milliseconds for males; >480 milliseconds for females) and the ESC. One boy (aged 9 years) experienced two shocks from an ICD and reported that he failed to take a prescribed beta blocker at the time of the incidents.
“With more than 650 athlete-years of follow-up, we report a low rate of LQTS-triggered cardiac events during sports,” researchers said. “Limitations include the small sample size, limited length of follow-up and unknown generalizability.”
Disclosure: See the study for a full list of relevant disclosures.