Long QT Syndrome

To the Editor.

Ackerman and Porter¹ report an interesting and important case of near-drowning in a child with long QT syndrome (LQTS). As they point out, their case is not likely to be unique, as swimming and diving are often reported in histories of children with LQTS and is provocative of arrhythmias if used in screening.² We have personal experience of a young woman whose LQTS was not diagnosed until age 14 when she required resuscitation from ventricular fibrillation following track practice. Years before, she had been assessed by a pediatric cardiologist after an episode of near-drowning at age 8.³ The delay in diagnosis in our case did not result from a prolonged QT interval being overlooked, but rather because this young woman had a normal QTc and exercise test at that evaluation!

The tragedy of misdiagnosis as either benign syncope or seizures often encountered in LQTS is a result of several factors of which pediatricians need to be made aware. First, despite the syncope or seizure-like episode spontaneously remitting as in more benign conditions, it …