Arrhythmias & electrophysiology

Long QT syndrome in children and adolescents: risk factors and outcomes in a large German cohort

Eur Heart JPublished Retrospective cohort study

Authors' conclusion

Paediatric LQTS patients are at risk for life-threatening arrhythmias at <18 years of age

Study context

Population
Children and adolescents with long QT syndrome (LQTS), Germany
Participants
548 children
Outcome
Major arrhythmic event:
  • SCD
  • Aborted cardiac arrest
  • Appropriate ICD therapy
Follow-up
Before age 18 years
Methodological detailsmulticentre, 12 German tertiary care centres
  • Multicentre
  • 12 German tertiary care centres

Main finding

As reported in the abstract

Major arrhythmic event
Primary outcome reached
58 patients (10.6%)
Sudden cardiac death (SCD)
7 (1.3%)
Aborted cardiac arrest
40 (7.3%)
Appropriate implantable cardioverter-defibrillator (ICD) therapy
11 (2.0%)
Overall event rate
1.0 per 100 patient-years at risk

Observational data: associations, not effects.

Further findings

Risk factors for major arrhythmic event (multivariate analysis)

HR (95% CI)P value
LQT32.5 (1.1–5.6)P = 0.03
Syncope3.0 (1.7–5.5)P < 0.01
Absence of cardiac medication9.5 (5.3–17.3)P < 0.01
QTc ≥500 ms2.9 (1.4–6.3)P < 0.01

Risk factors in subanalyses

Pathogenic variant in KCNH2 pore region (LQT2) and younger age at symptom presentation identified as risk factors

ICD implantation and appropriate therapy · before 18 years of age

ICD implanted
73 patients (13.3%)
Appropriate therapy among ICD recipients
25 (34.2%)
Received cardiac medication
92.1%

Original publication

Long QT syndrome in children and adolescents: risk factors and outcomes in a large German cohort. Eur Heart J. Published 2 July 2025. doi:10.1093/eurheartj/ehaf365

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