In a Swedish registry of long QT syndrome patients, 30% received an implantable cardioverter defibrillator without a strong guideline indication, particularly asymptomatic LQT3 patients.
Observational (n=109)
Yes
How well does the use of ICD treatment in Swedish LQTS patients adhere to international guidelines?
Thirty percent of Swedish LQTS patients received an ICD without a strong guideline indication, highlighting a gap between international guidelines and clinical practice.
OBJECTIVES: Implantable cardioverter defibrillator (ICD) treatment is effective among long QT syndrome (LQTS) patients at a high risk of sudden cardiac death. Previous studies show that the international guidelines are not always followed, and that risk stratification may be based on genotype rather than individual risk profile. We analysed data from the Swedish ICD & Pacemaker Registry and medical records to examine how international guidelines were followed with regards to phenotype and genotype. METHODS AND RESULTS: ICD treatment was used in 150 Swedish LQTS patients from 1989-2013. The annual number of implantations increased over the study period. A total of 109 patients were included in the analysis. Most patients (91%) were symptomatic before the implantation. Seventy percent of patients who received ICD treatment met the 2006 Class I or Class IIa recommendations for LQTS treatment. Thirty-one percent of the LQT3 patients received ICD treatment despite being asymptomatic. Among LQT1 patients, 45% received ICD treatment after syncope despite beta-blockers. CONCLUSIONS: Thirty percent of Swedish LQTS patients with ICD received the treatment without a strong indication based on international guidelines. LQT3 patients were over-represented among asymptomatic patients. Many LQT1 patients received ICD despite the known effect of beta-blockers in this group.
Sundström et al. (Mon,) conducted a observational in Long QT syndrome (LQTS) (n=109). Implantable cardioverter defibrillator (ICD) was evaluated on Adherence to 2006 Class I or Class IIa recommendations for LQTS treatment. In a Swedish registry of long QT syndrome patients, 30% received an implantable cardioverter defibrillator without a strong guideline indication, particularly asymptomatic LQT3 patients.