Review and management of the dental patient with Long QT syndrome (LQTS)

Abstract

Long QT syndrome (LQTS) is a unique cardiovascular condition, with both congenital and acquired forms that afflict patients. These patients show a lengthening of the repolarization phase of the cardiac cycle, which can be best visualized on an electrocardiogram (ECG). The ECG changes can include QT interval (the time between the start of the Q wave and the end of the T wave, as seen on an ECG) and T wave abnormalities, as well as progression to torsades de pointes and ventricular fibrillation. The ECG changes are most commonly elicited by physical activity, emotional stress, and certain medications. This condition represents a challenge for the oral and maxillofacial surgeon. Patients with LQTS must receive proper medical management and a controlled and anxiety-free surgical environment. The purpose of this article was to present a review of LQTS and provide recommendations for effective surgical management. Additionally, a case report of a patient with LQTS, treated by one of the authors, has been included.

Figures

Top: ECG showing normal sinus rhythm with a normal QT interval. Middle: ECG showing a lengthening of the QT interval, as seen in long QT syndrome. Bottom: ECG showing polymorphic ventricular tachycardia. Note the characteristic twisting of QRS complexes of torsades de pointes. Images are for illustration purposes only and are not to scale.