Primary prevention
Because congenital LQTS is an inherited condition, primary prevention is not applicable. Early detection and treatment of hypokalemia and hypomagnesemia, and avoidance of drugs known to prolong the QT interval where possible, may prevent some cases of acquired LQTS.
Patients starting QT-prolonging anticancer therapy should have a baseline assessment for underlying risk factors and have their QT interval monitored before and during treatment.[23][24]
Secondary prevention
Patients should be advised to avoid drugs known to have the potential to prolong the QT interval or cause depletion of potassium and/or magnesium, such as quinidine, procainamide, sotalol, amiodarone, disopyramide, dofetilide, phenothiazines, tricyclic antidepressants, and methadone.[21][22] Credible Meds (Arizona CERT): drugs that prolong the QT interval Opens in new window Energy drinks that contain large amounts of caffeine may lead to QT prolongation and caution should be exercised in patients with LQTS.[63]
Patients with LQT2 should avoid startling acoustic stimulation such as alarm clocks. In general, competitive sports or similar extreme exertion should be avoided by patients with LQTS. However, patients who wish to engage in competitive sports should be referred for expert evaluation for risk stratification.[3]
Parental genetic counseling and testing prior to conception is recommended to determine the potential risk of having a child affected with LQTS.
In-vitro fertilization, with implantation of a fertilized oocyte confirmed to be free of the known mutation, may be an option for parents carrying an affected gene.
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