Prolonged QT

Clarisa Y Garcia,MD
• Genetically transmitted cardiac arrhythmia

• Ion channel protein abnormalities: Sodium,

Potassium and Calcium Channels

• Electrocardiographic abnormalities

• High incidence of syncope and sudden cardiac

death.
Corrected QT (QTC) = Bazett's Formula =
QT Interval / √ (RR interval)
Normal 0.42
• Unexplained bradycardia, especially in the newborn

• Syncope, especially when associated with a triggering event

• Epilepsy, especially not controlled by conventional medications

• Palpitations

• Aborted or sudden cardiac death in the patient or family

history of sudden cardiac death

• SIDS

• Depressive symptoms
 Diagnostic Testing
• EKG
– Children and adolescents (<15 y)>0.46
– Lead II and V5

• Epinephrine QT stress testing

• Genetics
– 50% of pts with Long QT have known mutation
 Treatment
• Short-term treatment :preventing the recurrences of torsade de pointes 
– intravenous magnesium and potassium administration,
– temporary cardiac pacing
– withdrawal of the offending agent
– correction of electrolyte imbalance
– intravenous isoproterenol

• Long-term treatment: reducing the QT interval duration and preventing

torsade de pointes and sudden death.
– Beta-blockers
– implantable cardioverter-defibrillator (ICD)
– pacing, left cardiac sympathetic denervation

Lifestyle modification to avoid triggers

 Management
• Follow up with Cardiology

• CPR training

• Drugs to avoid: Arizona Center for Education and

Research on Therapeutics Web site.

• Familial Work up