Commentary
Referring back to the case with the 16-years-old LQT2 female athlete: should she receive an ICD to prevent SCD?
Study one and two showed that ICD treatment is effective in preventing sudden cardiac death, but also involves a lot of side effects. The amount of appropriate shocks equalled more or less the frequency of inappropriate shocks. Besides these inappropriate shocks, other adverse events were experienced by 1:3-4 patients. Study 2 showed that no LQT-related deaths occurred among the 408 non-ICD treated patients and therefore, the vast majority of LQTS patients might be managed sufficiently without an ICD.
Study 2 determined that the most common reason for inappropriate ICD discharge was T-wave oversensing, which was more prevalent in …show more content…
Study 3 showed that no sports-related events occurred among the 130 athletes who chose to continue sports participation after LQTS diagnosis. The boy who did experience a sporting-related event had a much worse disease phenotype than the patient described in the case. Additionally, the cardiac events occurred as a result of his non-compliance with beta-blocker therapy. This LQT2 patient might therefore not necessarily cease her sporting participation, on condition that therapy compliance is guaranteed. Importantly, the patient possesses two major risk factors for non-compliance: being adolescent and athlete. Most adolescents have less understanding of their illness and the consequences of medications on their health status. Additionally, they want to test boundaries, often leading to risky behaviour. Secondly, the suggested beta-blockade medication is known for its negative effects on sports performances. Therefore, it is very important to emphasize the importance of compliance if she truly wants to remain involved in
Referring back to the case with the 16-years-old LQT2 female athlete: should she receive an ICD to prevent SCD?
Study one and two showed that ICD treatment is effective in preventing sudden cardiac death, but also involves a lot of side effects. The amount of appropriate shocks equalled more or less the frequency of inappropriate shocks. Besides these inappropriate shocks, other adverse events were experienced by 1:3-4 patients. Study 2 showed that no LQT-related deaths occurred among the 408 non-ICD treated patients and therefore, the vast majority of LQTS patients might be managed sufficiently without an ICD.
Study 2 determined that the most common reason for inappropriate ICD discharge was T-wave oversensing, which was more prevalent in …show more content…
Study 3 showed that no sports-related events occurred among the 130 athletes who chose to continue sports participation after LQTS diagnosis. The boy who did experience a sporting-related event had a much worse disease phenotype than the patient described in the case. Additionally, the cardiac events occurred as a result of his non-compliance with beta-blocker therapy. This LQT2 patient might therefore not necessarily cease her sporting participation, on condition that therapy compliance is guaranteed. Importantly, the patient possesses two major risk factors for non-compliance: being adolescent and athlete. Most adolescents have less understanding of their illness and the consequences of medications on their health status. Additionally, they want to test boundaries, often leading to risky behaviour. Secondly, the suggested beta-blockade medication is known for its negative effects on sports performances. Therefore, it is very important to emphasize the importance of compliance if she truly wants to remain involved in