Hobbs et al identified risk factors for aborted cardiac arrest or sudden cardiac death in adolescents with the long QT syndrome. This can help identify adolescents who may benefit from closer monitoring and more aggressive management. The authors are from the University of Rochester, the Mayo Clinic, Bikur Cholim Hospital (Jerusalem), Case Western Reserve University, Niguarda Hospital (Milan), University of Milan, Baylor College of Medicine and the University of Utah.
Patient selection: age 10 years at entry
Parameters:
(1) number and pattern of syncopal episodes in past 10 years
(2) QTc in milliseconds
(3) gender and age
(4) beta-blocker therapy
Parameter
Finding
Hazard Ratio
syncopal episodes
none in past 10 years
1
none in <= 2 years AND 1 in years 2.01 - 10
2.7
none in <= 2 years AND >= 2 in years 2.01 - 10
5.8
1 in <= 2 years
11.7
>= 2 in <= 2 years
18.1
QTc
< 530 milliseconds
1
>= 530 milliseconds
2.3
gender and age
male AND 10-12 years
4.0 (vs female 10-12 years old)
other
1
beta blocker therapy
none
1
in patient with syncopal episode within past 2 years
0.36
in patient with syncopal episode 2.01-10 years ago
1
cumulative product =
= PRODUCT(all 4 parameters)
Interpretation:
• lowest cumulative product: 1
• highest cumulative risk: 166.5
• Therapy with a beta-blocker in a high risk patient can significantly reduce risk.
To read more or access our algorithms and calculators, please log in or register.
