Monitoring
EGCs are undertaken routinely on an annual or biannual basis and after initiation or adjustment of beta-blocker therapy.
Exercise testing and/or Holter monitoring is done to confirm adequate beta-blockade after the initiation of beta-blockers, assess ongoing adequacy of beta-blockade, and augment dosage as necessary in children undergoing somatic growth.
Serum electrolyte measurement to monitor for hypokalemia, hypomagnesemia, and hypocalcemia.
Medication review for drugs contraindicated in LQTS, such as quinidine, procainamide, sotalol, amiodarone, disopyramide, dofetilide, phenothiazines, and tricyclic antidepressants. Credible Meds (Arizona CERT): drugs that prolong the QT interval Opens in new window
Symptom history for detection of interim syncope.
Consideration of genotyping to facilitate family evaluation, and confirmation of full evaluation of family.
Patients with LQTS who undergo general anesthesia require careful perioperative monitoring, as they are at high risk of torsades de pointes perioperatively. Little is known about the effects of LQTS during pregnancy, but the incidence of dysrhythmia increases postpartum, so careful monitoring of LQTS patients in the postpartum period is also required.[62]
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