10th May 2025

Management

Torsades de pointes should be terminated by intravenous Magnesium sulfate. Alternatives are, overdrive pacing and intravenous isoprenaline. Although, isoprenaline should be avoided in congenital long QT syndrome.
Avoidance of QT prolonging drugs, electrolyte imbalance and genotype specific triggers in all patients
Asymptomatic congenital LQTS are advised to be treated with beta blockers
Implantable cardioverted defibrillator (ICD) implantation should be considered in patients with previous cardiac arrest, syncope despite beta blockers and in asymptomatic cases with QTc >500 msec
Left cardiac sympathetic denervation can be considered in patients who remain symptomatic.

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