Long QT syndrome - Mark Dayer



Long QT syndromeDefinitionLong QT syndrome (LQTS) can be defined asan inheritedcondition associated with a prolongation of theQT interval on the ECG characterized by syncope,seizures, and sudden death secondary to ventricular arrhythmia,specifically torsade de pointes ADDIN EN.CITE <EndNote><Cite><Author>Schwartz</Author><Year>1987</Year><RecNum>4967</RecNum><record><rec-number>4967</rec-number><foreign-keys><key app="EN" db-id="fr0tzpp2v9xtpoewa52p0evqsz2dvvst9sd0">4967</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Schwartz, P. J.</author></authors></contributors><titles><title>[From clinical medicine to electrophysiology. The case of the long QT syndrome]</title><secondary-title>Cardiologia</secondary-title></titles><periodical><full-title>Cardiologia</full-title></periodical><pages>1685-7</pages><volume>32</volume><number>12</number><edition>1987/12/01</edition><keywords><keyword>Adolescent</keyword><keyword>Arrhythmias, Cardiac/*diagnosis</keyword><keyword>Cardiac Pacing, Artificial</keyword><keyword>Child</keyword><keyword>Child, Preschool</keyword><keyword>Electrophysiology</keyword><keyword>Humans</keyword><keyword>Long QT Syndrome/*diagnosis/physiopathology</keyword><keyword>Prognosis</keyword></keywords><dates><year>1987</year><pub-dates><date>Dec</date></pub-dates></dates><orig-pub>Dalla clinica all&apos;elettrofisiologia. Il caso della sindrome del QT lungo.</orig-pub><isbn>0393-1978 (Print)</isbn><accession-num>3447719</accession-num><urls><related-urls><url>. It may be congenital or acquired.Prevalence of congenital LQTSA recent study of 43 080 white infants 15 to 25 days old identified 17 who were affected by LQTS, demonstrating a prevalence of at least 1:2534 apparently healthy live births (95% confidence interval, 1:1583 to 1:4350) ADDIN EN.CITE <EndNote><Cite><Author>Schwartz</Author><Year>2009</Year><RecNum>16</RecNum><record><rec-number>16</rec-number><foreign-keys><key app="EN" db-id="fr0tzpp2v9xtpoewa52p0evqsz2dvvst9sd0">16</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Schwartz, P. J.</author><author>Stramba-Badiale, M.</author><author>Crotti, L.</author><author>Pedrazzini, M.</author><author>Besana, A.</author><author>Bosi, G.</author><author>Gabbarini, F.</author><author>Goulene, K.</author><author>Insolia, R.</author><author>Mannarino, S.</author><author>Mosca, F.</author><author>Nespoli, L.</author><author>Rimini, A.</author><author>Rosati, E.</author><author>Salice, P.</author><author>Spazzolini, C.</author></authors></contributors><auth-address>Department of Lung, Blood, and Heart, University of Pavia, Pavia, Italy. peter.schwartz@unipv.it</auth-address><titles><title>Prevalence of the congenital long-QT syndrome</title><secondary-title>Circulation</secondary-title></titles><periodical><full-title>Circulation</full-title></periodical><pages>1761-7</pages><volume>120</volume><number>18</number><edition>2009/10/21</edition><dates><year>2009</year><pub-dates><date>Nov 3</date></pub-dates></dates><isbn>1524-4539 (Electronic)</isbn><accession-num>19841298</accession-num><urls><related-urls><url> [pii]&#xD;10.1161/CIRCULATIONAHA.109.863209</electronic-resource-num><language>eng</language></record></Cite></EndNote>2. This is now considered to be the most authoritative estimate of the prevalence of this condition.DiagnosisThe ECGThe ECG is the key to diagnosis. Generally, at rest, in men at QTc of > 450ms or in women > 470ms is considered abnormal (Table 1). There are often associated T-wave abnormlities, which may give a clue as to the genotype. However, interpreting the QT interval is by no means straight-forward and there remains controversyPEVuZE5vdGU+PENpdGU+PEF1dGhvcj5SYXV0YWhhcmp1PC9BdXRob3I+PFllYXI+MjAwOTwvWWVh

cj48UmVjTnVtPjUyNjQ8L1JlY051bT48cmVjb3JkPjxyZWMtbnVtYmVyPjUyNjQ8L3JlYy1udW1i

ZXI+PGZvcmVpZ24ta2V5cz48a2V5IGFwcD0iRU4iIGRiLWlkPSJmcjB0enBwMnY5eHRwb2V3YTUy

cDBldnFzejJkdnZzdDlzZDAiPjUyNjQ8L2tleT48L2ZvcmVpZ24ta2V5cz48cmVmLXR5cGUgbmFt

ZT0iSm91cm5hbCBBcnRpY2xlIj4xNzwvcmVmLXR5cGU+PGNvbnRyaWJ1dG9ycz48YXV0aG9ycz48

YXV0aG9yPlJhdXRhaGFyanUsIFAuIE0uPC9hdXRob3I+PGF1dGhvcj5TdXJhd2ljeiwgQi48L2F1

dGhvcj48YXV0aG9yPkdldHRlcywgTC4gUy48L2F1dGhvcj48YXV0aG9yPkJhaWxleSwgSi4gSi48

L2F1dGhvcj48YXV0aG9yPkNoaWxkZXJzLCBSLjwvYXV0aG9yPjxhdXRob3I+RGVhbCwgQi4gSi48

L2F1dGhvcj48YXV0aG9yPkdvcmdlbHMsIEEuPC9hdXRob3I+PGF1dGhvcj5IYW5jb2NrLCBFLiBX

LjwvYXV0aG9yPjxhdXRob3I+Sm9zZXBoc29uLCBNLjwvYXV0aG9yPjxhdXRob3I+S2xpZ2ZpZWxk

LCBQLjwvYXV0aG9yPjxhdXRob3I+S29ycywgSi4gQS48L2F1dGhvcj48YXV0aG9yPk1hY2Zhcmxh

bmUsIFAuPC9hdXRob3I+PGF1dGhvcj5NYXNvbiwgSi4gVy48L2F1dGhvcj48YXV0aG9yPk1pcnZp

cywgRC4gTS48L2F1dGhvcj48YXV0aG9yPk9raW4sIFAuPC9hdXRob3I+PGF1dGhvcj5QYWhsbSwg

Ty48L2F1dGhvcj48YXV0aG9yPnZhbiBIZXJwZW4sIEcuPC9hdXRob3I+PGF1dGhvcj5XYWduZXIs

IEcuIFMuPC9hdXRob3I+PGF1dGhvcj5XZWxsZW5zLCBILjwvYXV0aG9yPjwvYXV0aG9ycz48L2Nv

bnRyaWJ1dG9ycz48dGl0bGVzPjx0aXRsZT5BSEEvQUNDRi9IUlMgcmVjb21tZW5kYXRpb25zIGZv

ciB0aGUgc3RhbmRhcmRpemF0aW9uIGFuZCBpbnRlcnByZXRhdGlvbiBvZiB0aGUgZWxlY3Ryb2Nh

cmRpb2dyYW06IHBhcnQgSVY6IHRoZSBTVCBzZWdtZW50LCBUIGFuZCBVIHdhdmVzLCBhbmQgdGhl

IFFUIGludGVydmFsOiBhIHNjaWVudGlmaWMgc3RhdGVtZW50IGZyb20gdGhlIEFtZXJpY2FuIEhl

YXJ0IEFzc29jaWF0aW9uIEVsZWN0cm9jYXJkaW9ncmFwaHkgYW5kIEFycmh5dGhtaWFzIENvbW1p

dHRlZSwgQ291bmNpbCBvbiBDbGluaWNhbCBDYXJkaW9sb2d5OyB0aGUgQW1lcmljYW4gQ29sbGVn

ZSBvZiBDYXJkaW9sb2d5IEZvdW5kYXRpb247IGFuZCB0aGUgSGVhcnQgUmh5dGhtIFNvY2lldHk6

IGVuZG9yc2VkIGJ5IHRoZSBJbnRlcm5hdGlvbmFsIFNvY2lldHkgZm9yIENvbXB1dGVyaXplZCBF

bGVjdHJvY2FyZGlvbG9neTwvdGl0bGU+PHNlY29uZGFyeS10aXRsZT5DaXJjdWxhdGlvbjwvc2Vj

b25kYXJ5LXRpdGxlPjwvdGl0bGVzPjxwZXJpb2RpY2FsPjxmdWxsLXRpdGxlPkNpcmN1bGF0aW9u

PC9mdWxsLXRpdGxlPjwvcGVyaW9kaWNhbD48cGFnZXM+ZTI0MS01MDwvcGFnZXM+PHZvbHVtZT4x

MTk8L3ZvbHVtZT48bnVtYmVyPjEwPC9udW1iZXI+PGVkaXRpb24+MjAwOS8wMi8yMTwvZWRpdGlv

bj48a2V5d29yZHM+PGtleXdvcmQ+QXJyaHl0aG1pYXMsIENhcmRpYWMvKmRpYWdub3Npcy8qcGh5

c2lvcGF0aG9sb2d5PC9rZXl3b3JkPjxrZXl3b3JkPkJ1bmRsZS1CcmFuY2ggQmxvY2svZGlhZ25v

c2lzL3BoeXNpb3BhdGhvbG9neTwva2V5d29yZD48a2V5d29yZD5FbGVjdHJvY2FyZGlvZ3JhcGh5

L21ldGhvZHMvKnN0YW5kYXJkczwva2V5d29yZD48a2V5d29yZD5IZWFydCBDb25kdWN0aW9uIFN5

c3RlbS8qcGh5c2lvcGF0aG9sb2d5PC9rZXl3b3JkPjxrZXl3b3JkPkhlYXJ0IERpc2Vhc2VzL2Rp

YWdub3Npcy9waHlzaW9wYXRob2xvZ3k8L2tleXdvcmQ+PGtleXdvcmQ+SHVtYW5zPC9rZXl3b3Jk

PjxrZXl3b3JkPkltYWdlIFByb2Nlc3NpbmcsIENvbXB1dGVyLUFzc2lzdGVkPC9rZXl3b3JkPjxr

ZXl3b3JkPk15b2NhcmRpYWwgSXNjaGVtaWEvZGlhZ25vc2lzL3BoeXNpb3BhdGhvbG9neTwva2V5

d29yZD48L2tleXdvcmRzPjxkYXRlcz48eWVhcj4yMDA5PC95ZWFyPjxwdWItZGF0ZXM+PGRhdGU+

TWFyIDE3PC9kYXRlPjwvcHViLWRhdGVzPjwvZGF0ZXM+PGlzYm4+MTUyNC00NTM5IChFbGVjdHJv

bmljKTwvaXNibj48YWNjZXNzaW9uLW51bT4xOTIyODgyMTwvYWNjZXNzaW9uLW51bT48dXJscz48

cmVsYXRlZC11cmxzPjx1cmw+aHR0cDovL3d3dy5uY2JpLm5sbS5uaWguZ292L2VudHJlei9xdWVy

eS5mY2dpP2NtZD1SZXRyaWV2ZSZhbXA7ZGI9UHViTWVkJmFtcDtkb3B0PUNpdGF0aW9uJmFtcDts

aXN0X3VpZHM9MTkyMjg4MjE8L3VybD48L3JlbGF0ZWQtdXJscz48L3VybHM+PGVsZWN0cm9uaWMt

cmVzb3VyY2UtbnVtPkNJUkNVTEFUSU9OQUhBLjEwOC4xOTEwOTYgW3BpaV0mI3hEOzEwLjExNjEv

Q0lSQ1VMQVRJT05BSEEuMTA4LjE5MTA5NjwvZWxlY3Ryb25pYy1yZXNvdXJjZS1udW0+PGxhbmd1

YWdlPmVuZzwvbGFuZ3VhZ2U+PC9yZWNvcmQ+PC9DaXRlPjxDaXRlPjxBdXRob3I+VGFnZ2FydDwv

QXV0aG9yPjxZZWFyPjIwMDc8L1llYXI+PFJlY051bT4xMDA0PC9SZWNOdW0+PHJlY29yZD48cmVj

LW51bWJlcj4xMDA0PC9yZWMtbnVtYmVyPjxmb3JlaWduLWtleXM+PGtleSBhcHA9IkVOIiBkYi1p

ZD0iZnIwdHpwcDJ2OXh0cG9ld2E1MnAwZXZxc3oyZHZ2c3Q5c2QwIj4xMDA0PC9rZXk+PC9mb3Jl

aWduLWtleXM+PHJlZi10eXBlIG5hbWU9IkpvdXJuYWwgQXJ0aWNsZSI+MTc8L3JlZi10eXBlPjxj

b250cmlidXRvcnM+PGF1dGhvcnM+PGF1dGhvcj5UYWdnYXJ0LCBOLiBXLjwvYXV0aG9yPjxhdXRo

b3I+SGFnbHVuZCwgQy4gTS48L2F1dGhvcj48YXV0aG9yPlRlc3RlciwgRC4gSi48L2F1dGhvcj48

YXV0aG9yPkFja2VybWFuLCBNLiBKLjwvYXV0aG9yPjwvYXV0aG9ycz48L2NvbnRyaWJ1dG9ycz48

YXV0aC1hZGRyZXNzPkRlcGFydG1lbnQgb2YgUGVkaWF0cmljcy9EaXZpc2lvbiBvZiBQZWRpYXRy

aWMgQ2FyZGlvbG9neSwgTWF5byBDbGluaWMgQ29sbGVnZSBvZiBNZWRpY2luZSwgUm9jaGVzdGVy

LCBNTiA1NTkwNSwgVVNBLjwvYXV0aC1hZGRyZXNzPjx0aXRsZXM+PHRpdGxlPkRpYWdub3N0aWMg

bWlzY3VlcyBpbiBjb25nZW5pdGFsIGxvbmctUVQgc3luZHJvbWU8L3RpdGxlPjxzZWNvbmRhcnkt

dGl0bGU+Q2lyY3VsYXRpb248L3NlY29uZGFyeS10aXRsZT48L3RpdGxlcz48cGVyaW9kaWNhbD48

ZnVsbC10aXRsZT5DaXJjdWxhdGlvbjwvZnVsbC10aXRsZT48L3BlcmlvZGljYWw+PHBhZ2VzPjI2

MTMtMjA8L3BhZ2VzPjx2b2x1bWU+MTE1PC92b2x1bWU+PG51bWJlcj4yMDwvbnVtYmVyPjxlZGl0

aW9uPjIwMDcvMDUvMTY8L2VkaXRpb24+PGtleXdvcmRzPjxrZXl3b3JkPkFkb2xlc2NlbnQ8L2tl

eXdvcmQ+PGtleXdvcmQ+QWR1bHQ8L2tleXdvcmQ+PGtleXdvcmQ+QWdlZDwva2V5d29yZD48a2V5

d29yZD5DaGlsZDwva2V5d29yZD48a2V5d29yZD5DaGlsZCwgUHJlc2Nob29sPC9rZXl3b3JkPjxr

ZXl3b3JkPkRpYWdub3N0aWMgRXJyb3JzLypzdGF0aXN0aWNzICZhbXA7IG51bWVyaWNhbCBkYXRh

PC9rZXl3b3JkPjxrZXl3b3JkPipFbGVjdHJvY2FyZGlvZ3JhcGh5PC9rZXl3b3JkPjxrZXl3b3Jk

PkZlbWFsZTwva2V5d29yZD48a2V5d29yZD5HZW5vdHlwZTwva2V5d29yZD48a2V5d29yZD5IdW1h

bnM8L2tleXdvcmQ+PGtleXdvcmQ+SW5mYW50PC9rZXl3b3JkPjxrZXl3b3JkPkluZmFudCwgTmV3

Ym9ybjwva2V5d29yZD48a2V5d29yZD5Mb25nIFFUIFN5bmRyb21lL2Nvbmdlbml0YWwvKmRpYWdu

b3Npcy9nZW5ldGljczwva2V5d29yZD48a2V5d29yZD5NYWxlPC9rZXl3b3JkPjxrZXl3b3JkPk1p

ZGRsZSBBZ2VkPC9rZXl3b3JkPjxrZXl3b3JkPlByb2JhYmlsaXR5PC9rZXl3b3JkPjxrZXl3b3Jk

PlJlZmVyZW5jZSBWYWx1ZXM8L2tleXdvcmQ+PGtleXdvcmQ+UmV0cm9zcGVjdGl2ZSBTdHVkaWVz

PC9rZXl3b3JkPjxrZXl3b3JkPlN5bmNvcGUvZXRpb2xvZ3k8L2tleXdvcmQ+PC9rZXl3b3Jkcz48

ZGF0ZXM+PHllYXI+MjAwNzwveWVhcj48cHViLWRhdGVzPjxkYXRlPk1heSAyMjwvZGF0ZT48L3B1

Yi1kYXRlcz48L2RhdGVzPjxpc2JuPjE1MjQtNDUzOSAoRWxlY3Ryb25pYyk8L2lzYm4+PGFjY2Vz

c2lvbi1udW0+MTc1MDI1NzU8L2FjY2Vzc2lvbi1udW0+PHVybHM+PHJlbGF0ZWQtdXJscz48dXJs

Pmh0dHA6Ly93d3cubmNiaS5ubG0ubmloLmdvdi9lbnRyZXovcXVlcnkuZmNnaT9jbWQ9UmV0cmll

dmUmYW1wO2RiPVB1Yk1lZCZhbXA7ZG9wdD1DaXRhdGlvbiZhbXA7bGlzdF91aWRzPTE3NTAyNTc1

PC91cmw+PC9yZWxhdGVkLXVybHM+PC91cmxzPjxlbGVjdHJvbmljLXJlc291cmNlLW51bT5DSVJD

VUxBVElPTkFIQS4xMDYuNjYxMDgyIFtwaWldJiN4RDsxMC4xMTYxL0NJUkNVTEFUSU9OQUhBLjEw

Ni42NjEwODI8L2VsZWN0cm9uaWMtcmVzb3VyY2UtbnVtPjxsYW5ndWFnZT5lbmc8L2xhbmd1YWdl

PjwvcmVjb3JkPjwvQ2l0ZT48L0VuZE5vdGU+AAAA

ADDIN EN.CITE PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5SYXV0YWhhcmp1PC9BdXRob3I+PFllYXI+MjAwOTwvWWVh

cj48UmVjTnVtPjUyNjQ8L1JlY051bT48cmVjb3JkPjxyZWMtbnVtYmVyPjUyNjQ8L3JlYy1udW1i

ZXI+PGZvcmVpZ24ta2V5cz48a2V5IGFwcD0iRU4iIGRiLWlkPSJmcjB0enBwMnY5eHRwb2V3YTUy

cDBldnFzejJkdnZzdDlzZDAiPjUyNjQ8L2tleT48L2ZvcmVpZ24ta2V5cz48cmVmLXR5cGUgbmFt

ZT0iSm91cm5hbCBBcnRpY2xlIj4xNzwvcmVmLXR5cGU+PGNvbnRyaWJ1dG9ycz48YXV0aG9ycz48

YXV0aG9yPlJhdXRhaGFyanUsIFAuIE0uPC9hdXRob3I+PGF1dGhvcj5TdXJhd2ljeiwgQi48L2F1

dGhvcj48YXV0aG9yPkdldHRlcywgTC4gUy48L2F1dGhvcj48YXV0aG9yPkJhaWxleSwgSi4gSi48

L2F1dGhvcj48YXV0aG9yPkNoaWxkZXJzLCBSLjwvYXV0aG9yPjxhdXRob3I+RGVhbCwgQi4gSi48

L2F1dGhvcj48YXV0aG9yPkdvcmdlbHMsIEEuPC9hdXRob3I+PGF1dGhvcj5IYW5jb2NrLCBFLiBX

LjwvYXV0aG9yPjxhdXRob3I+Sm9zZXBoc29uLCBNLjwvYXV0aG9yPjxhdXRob3I+S2xpZ2ZpZWxk

LCBQLjwvYXV0aG9yPjxhdXRob3I+S29ycywgSi4gQS48L2F1dGhvcj48YXV0aG9yPk1hY2Zhcmxh

bmUsIFAuPC9hdXRob3I+PGF1dGhvcj5NYXNvbiwgSi4gVy48L2F1dGhvcj48YXV0aG9yPk1pcnZp

cywgRC4gTS48L2F1dGhvcj48YXV0aG9yPk9raW4sIFAuPC9hdXRob3I+PGF1dGhvcj5QYWhsbSwg

Ty48L2F1dGhvcj48YXV0aG9yPnZhbiBIZXJwZW4sIEcuPC9hdXRob3I+PGF1dGhvcj5XYWduZXIs

IEcuIFMuPC9hdXRob3I+PGF1dGhvcj5XZWxsZW5zLCBILjwvYXV0aG9yPjwvYXV0aG9ycz48L2Nv

bnRyaWJ1dG9ycz48dGl0bGVzPjx0aXRsZT5BSEEvQUNDRi9IUlMgcmVjb21tZW5kYXRpb25zIGZv

ciB0aGUgc3RhbmRhcmRpemF0aW9uIGFuZCBpbnRlcnByZXRhdGlvbiBvZiB0aGUgZWxlY3Ryb2Nh

cmRpb2dyYW06IHBhcnQgSVY6IHRoZSBTVCBzZWdtZW50LCBUIGFuZCBVIHdhdmVzLCBhbmQgdGhl

IFFUIGludGVydmFsOiBhIHNjaWVudGlmaWMgc3RhdGVtZW50IGZyb20gdGhlIEFtZXJpY2FuIEhl

YXJ0IEFzc29jaWF0aW9uIEVsZWN0cm9jYXJkaW9ncmFwaHkgYW5kIEFycmh5dGhtaWFzIENvbW1p

dHRlZSwgQ291bmNpbCBvbiBDbGluaWNhbCBDYXJkaW9sb2d5OyB0aGUgQW1lcmljYW4gQ29sbGVn

ZSBvZiBDYXJkaW9sb2d5IEZvdW5kYXRpb247IGFuZCB0aGUgSGVhcnQgUmh5dGhtIFNvY2lldHk6

IGVuZG9yc2VkIGJ5IHRoZSBJbnRlcm5hdGlvbmFsIFNvY2lldHkgZm9yIENvbXB1dGVyaXplZCBF

bGVjdHJvY2FyZGlvbG9neTwvdGl0bGU+PHNlY29uZGFyeS10aXRsZT5DaXJjdWxhdGlvbjwvc2Vj

b25kYXJ5LXRpdGxlPjwvdGl0bGVzPjxwZXJpb2RpY2FsPjxmdWxsLXRpdGxlPkNpcmN1bGF0aW9u

PC9mdWxsLXRpdGxlPjwvcGVyaW9kaWNhbD48cGFnZXM+ZTI0MS01MDwvcGFnZXM+PHZvbHVtZT4x

MTk8L3ZvbHVtZT48bnVtYmVyPjEwPC9udW1iZXI+PGVkaXRpb24+MjAwOS8wMi8yMTwvZWRpdGlv

bj48a2V5d29yZHM+PGtleXdvcmQ+QXJyaHl0aG1pYXMsIENhcmRpYWMvKmRpYWdub3Npcy8qcGh5

c2lvcGF0aG9sb2d5PC9rZXl3b3JkPjxrZXl3b3JkPkJ1bmRsZS1CcmFuY2ggQmxvY2svZGlhZ25v

c2lzL3BoeXNpb3BhdGhvbG9neTwva2V5d29yZD48a2V5d29yZD5FbGVjdHJvY2FyZGlvZ3JhcGh5

L21ldGhvZHMvKnN0YW5kYXJkczwva2V5d29yZD48a2V5d29yZD5IZWFydCBDb25kdWN0aW9uIFN5

c3RlbS8qcGh5c2lvcGF0aG9sb2d5PC9rZXl3b3JkPjxrZXl3b3JkPkhlYXJ0IERpc2Vhc2VzL2Rp

YWdub3Npcy9waHlzaW9wYXRob2xvZ3k8L2tleXdvcmQ+PGtleXdvcmQ+SHVtYW5zPC9rZXl3b3Jk

PjxrZXl3b3JkPkltYWdlIFByb2Nlc3NpbmcsIENvbXB1dGVyLUFzc2lzdGVkPC9rZXl3b3JkPjxr

ZXl3b3JkPk15b2NhcmRpYWwgSXNjaGVtaWEvZGlhZ25vc2lzL3BoeXNpb3BhdGhvbG9neTwva2V5

d29yZD48L2tleXdvcmRzPjxkYXRlcz48eWVhcj4yMDA5PC95ZWFyPjxwdWItZGF0ZXM+PGRhdGU+

TWFyIDE3PC9kYXRlPjwvcHViLWRhdGVzPjwvZGF0ZXM+PGlzYm4+MTUyNC00NTM5IChFbGVjdHJv

bmljKTwvaXNibj48YWNjZXNzaW9uLW51bT4xOTIyODgyMTwvYWNjZXNzaW9uLW51bT48dXJscz48

cmVsYXRlZC11cmxzPjx1cmw+aHR0cDovL3d3dy5uY2JpLm5sbS5uaWguZ292L2VudHJlei9xdWVy

eS5mY2dpP2NtZD1SZXRyaWV2ZSZhbXA7ZGI9UHViTWVkJmFtcDtkb3B0PUNpdGF0aW9uJmFtcDts

aXN0X3VpZHM9MTkyMjg4MjE8L3VybD48L3JlbGF0ZWQtdXJscz48L3VybHM+PGVsZWN0cm9uaWMt

cmVzb3VyY2UtbnVtPkNJUkNVTEFUSU9OQUhBLjEwOC4xOTEwOTYgW3BpaV0mI3hEOzEwLjExNjEv

Q0lSQ1VMQVRJT05BSEEuMTA4LjE5MTA5NjwvZWxlY3Ryb25pYy1yZXNvdXJjZS1udW0+PGxhbmd1

YWdlPmVuZzwvbGFuZ3VhZ2U+PC9yZWNvcmQ+PC9DaXRlPjxDaXRlPjxBdXRob3I+VGFnZ2FydDwv

QXV0aG9yPjxZZWFyPjIwMDc8L1llYXI+PFJlY051bT4xMDA0PC9SZWNOdW0+PHJlY29yZD48cmVj

LW51bWJlcj4xMDA0PC9yZWMtbnVtYmVyPjxmb3JlaWduLWtleXM+PGtleSBhcHA9IkVOIiBkYi1p

ZD0iZnIwdHpwcDJ2OXh0cG9ld2E1MnAwZXZxc3oyZHZ2c3Q5c2QwIj4xMDA0PC9rZXk+PC9mb3Jl

aWduLWtleXM+PHJlZi10eXBlIG5hbWU9IkpvdXJuYWwgQXJ0aWNsZSI+MTc8L3JlZi10eXBlPjxj

b250cmlidXRvcnM+PGF1dGhvcnM+PGF1dGhvcj5UYWdnYXJ0LCBOLiBXLjwvYXV0aG9yPjxhdXRo

b3I+SGFnbHVuZCwgQy4gTS48L2F1dGhvcj48YXV0aG9yPlRlc3RlciwgRC4gSi48L2F1dGhvcj48

YXV0aG9yPkFja2VybWFuLCBNLiBKLjwvYXV0aG9yPjwvYXV0aG9ycz48L2NvbnRyaWJ1dG9ycz48

YXV0aC1hZGRyZXNzPkRlcGFydG1lbnQgb2YgUGVkaWF0cmljcy9EaXZpc2lvbiBvZiBQZWRpYXRy

aWMgQ2FyZGlvbG9neSwgTWF5byBDbGluaWMgQ29sbGVnZSBvZiBNZWRpY2luZSwgUm9jaGVzdGVy

LCBNTiA1NTkwNSwgVVNBLjwvYXV0aC1hZGRyZXNzPjx0aXRsZXM+PHRpdGxlPkRpYWdub3N0aWMg

bWlzY3VlcyBpbiBjb25nZW5pdGFsIGxvbmctUVQgc3luZHJvbWU8L3RpdGxlPjxzZWNvbmRhcnkt

dGl0bGU+Q2lyY3VsYXRpb248L3NlY29uZGFyeS10aXRsZT48L3RpdGxlcz48cGVyaW9kaWNhbD48

ZnVsbC10aXRsZT5DaXJjdWxhdGlvbjwvZnVsbC10aXRsZT48L3BlcmlvZGljYWw+PHBhZ2VzPjI2

MTMtMjA8L3BhZ2VzPjx2b2x1bWU+MTE1PC92b2x1bWU+PG51bWJlcj4yMDwvbnVtYmVyPjxlZGl0

aW9uPjIwMDcvMDUvMTY8L2VkaXRpb24+PGtleXdvcmRzPjxrZXl3b3JkPkFkb2xlc2NlbnQ8L2tl

eXdvcmQ+PGtleXdvcmQ+QWR1bHQ8L2tleXdvcmQ+PGtleXdvcmQ+QWdlZDwva2V5d29yZD48a2V5

d29yZD5DaGlsZDwva2V5d29yZD48a2V5d29yZD5DaGlsZCwgUHJlc2Nob29sPC9rZXl3b3JkPjxr

ZXl3b3JkPkRpYWdub3N0aWMgRXJyb3JzLypzdGF0aXN0aWNzICZhbXA7IG51bWVyaWNhbCBkYXRh

PC9rZXl3b3JkPjxrZXl3b3JkPipFbGVjdHJvY2FyZGlvZ3JhcGh5PC9rZXl3b3JkPjxrZXl3b3Jk

PkZlbWFsZTwva2V5d29yZD48a2V5d29yZD5HZW5vdHlwZTwva2V5d29yZD48a2V5d29yZD5IdW1h

bnM8L2tleXdvcmQ+PGtleXdvcmQ+SW5mYW50PC9rZXl3b3JkPjxrZXl3b3JkPkluZmFudCwgTmV3

Ym9ybjwva2V5d29yZD48a2V5d29yZD5Mb25nIFFUIFN5bmRyb21lL2Nvbmdlbml0YWwvKmRpYWdu

b3Npcy9nZW5ldGljczwva2V5d29yZD48a2V5d29yZD5NYWxlPC9rZXl3b3JkPjxrZXl3b3JkPk1p

ZGRsZSBBZ2VkPC9rZXl3b3JkPjxrZXl3b3JkPlByb2JhYmlsaXR5PC9rZXl3b3JkPjxrZXl3b3Jk

PlJlZmVyZW5jZSBWYWx1ZXM8L2tleXdvcmQ+PGtleXdvcmQ+UmV0cm9zcGVjdGl2ZSBTdHVkaWVz

PC9rZXl3b3JkPjxrZXl3b3JkPlN5bmNvcGUvZXRpb2xvZ3k8L2tleXdvcmQ+PC9rZXl3b3Jkcz48

ZGF0ZXM+PHllYXI+MjAwNzwveWVhcj48cHViLWRhdGVzPjxkYXRlPk1heSAyMjwvZGF0ZT48L3B1

Yi1kYXRlcz48L2RhdGVzPjxpc2JuPjE1MjQtNDUzOSAoRWxlY3Ryb25pYyk8L2lzYm4+PGFjY2Vz

c2lvbi1udW0+MTc1MDI1NzU8L2FjY2Vzc2lvbi1udW0+PHVybHM+PHJlbGF0ZWQtdXJscz48dXJs

Pmh0dHA6Ly93d3cubmNiaS5ubG0ubmloLmdvdi9lbnRyZXovcXVlcnkuZmNnaT9jbWQ9UmV0cmll

dmUmYW1wO2RiPVB1Yk1lZCZhbXA7ZG9wdD1DaXRhdGlvbiZhbXA7bGlzdF91aWRzPTE3NTAyNTc1

PC91cmw+PC9yZWxhdGVkLXVybHM+PC91cmxzPjxlbGVjdHJvbmljLXJlc291cmNlLW51bT5DSVJD

VUxBVElPTkFIQS4xMDYuNjYxMDgyIFtwaWldJiN4RDsxMC4xMTYxL0NJUkNVTEFUSU9OQUhBLjEw

Ni42NjEwODI8L2VsZWN0cm9uaWMtcmVzb3VyY2UtbnVtPjxsYW5ndWFnZT5lbmc8L2xhbmd1YWdl

PjwvcmVjb3JkPjwvQ2l0ZT48L0VuZE5vdGU+AAAA

ADDIN EN.CITE.DATA 3, 4. There is considerable variability in QTc duration during serial follow-upPEVuZE5vdGU+PENpdGU+PEF1dGhvcj5Hb2xkZW5iZXJnPC9BdXRob3I+PFllYXI+MjAwNjwvWWVh

cj48UmVjTnVtPjEzMDE8L1JlY051bT48cmVjb3JkPjxyZWMtbnVtYmVyPjEzMDE8L3JlYy1udW1i

ZXI+PGZvcmVpZ24ta2V5cz48a2V5IGFwcD0iRU4iIGRiLWlkPSJmcjB0enBwMnY5eHRwb2V3YTUy

cDBldnFzejJkdnZzdDlzZDAiPjEzMDE8L2tleT48L2ZvcmVpZ24ta2V5cz48cmVmLXR5cGUgbmFt

ZT0iSm91cm5hbCBBcnRpY2xlIj4xNzwvcmVmLXR5cGU+PGNvbnRyaWJ1dG9ycz48YXV0aG9ycz48

YXV0aG9yPkdvbGRlbmJlcmcsIEkuPC9hdXRob3I+PGF1dGhvcj5NYXRoZXcsIEouPC9hdXRob3I+

PGF1dGhvcj5Nb3NzLCBBLiBKLjwvYXV0aG9yPjxhdXRob3I+TWNOaXR0LCBTLjwvYXV0aG9yPjxh

dXRob3I+UGV0ZXJzb24sIEQuIFIuPC9hdXRob3I+PGF1dGhvcj5aYXJlYmEsIFcuPC9hdXRob3I+

PGF1dGhvcj5CZW5ob3JpbiwgSi48L2F1dGhvcj48YXV0aG9yPlpoYW5nLCBMLjwvYXV0aG9yPjxh

dXRob3I+VmluY2VudCwgRy4gTS48L2F1dGhvcj48YXV0aG9yPkFuZHJld3MsIE0uIEwuPC9hdXRo

b3I+PGF1dGhvcj5Sb2JpbnNvbiwgSi4gTC48L2F1dGhvcj48YXV0aG9yPk1vcnJheSwgQi48L2F1

dGhvcj48L2F1dGhvcnM+PC9jb250cmlidXRvcnM+PGF1dGgtYWRkcmVzcz5DYXJkaW9sb2d5IERp

dmlzaW9uLCBEZXBhcnRtZW50IG9mIE1lZGljaW5lLCBVbml2ZXJzaXR5IG9mIFJvY2hlc3RlciBN

ZWRpY2FsIENlbnRlciwgUm9jaGVzdGVyLCBOZXcgWW9yayAxNDY0MiwgVVNBLiBpbGFuLmdvbGRl

bmJlcmdAaGVhcnQucm9jaGVzdGVyLmVkdTwvYXV0aC1hZGRyZXNzPjx0aXRsZXM+PHRpdGxlPkNv

cnJlY3RlZCBRVCB2YXJpYWJpbGl0eSBpbiBzZXJpYWwgZWxlY3Ryb2NhcmRpb2dyYW1zIGluIGxv

bmcgUVQgc3luZHJvbWU6IHRoZSBpbXBvcnRhbmNlIG9mIHRoZSBtYXhpbXVtIGNvcnJlY3RlZCBR

VCBmb3IgcmlzayBzdHJhdGlmaWNhdGlvbjwvdGl0bGU+PHNlY29uZGFyeS10aXRsZT5KIEFtIENv

bGwgQ2FyZGlvbDwvc2Vjb25kYXJ5LXRpdGxlPjwvdGl0bGVzPjxwZXJpb2RpY2FsPjxmdWxsLXRp

dGxlPkogQW0gQ29sbCBDYXJkaW9sPC9mdWxsLXRpdGxlPjwvcGVyaW9kaWNhbD48cGFnZXM+MTA0

Ny01MjwvcGFnZXM+PHZvbHVtZT40ODwvdm9sdW1lPjxudW1iZXI+NTwvbnVtYmVyPjxlZGl0aW9u

PjIwMDYvMDkvMDU8L2VkaXRpb24+PGtleXdvcmRzPjxrZXl3b3JkPkFkb2xlc2NlbnQ8L2tleXdv

cmQ+PGtleXdvcmQ+QWdlIEZhY3RvcnM8L2tleXdvcmQ+PGtleXdvcmQ+Q2hpbGQ8L2tleXdvcmQ+

PGtleXdvcmQ+Q2hpbGQsIFByZXNjaG9vbDwva2V5d29yZD48a2V5d29yZD4qRWxlY3Ryb2NhcmRp

b2dyYXBoeTwva2V5d29yZD48a2V5d29yZD5GZW1hbGU8L2tleXdvcmQ+PGtleXdvcmQ+Rm9sbG93

LVVwIFN0dWRpZXM8L2tleXdvcmQ+PGtleXdvcmQ+SGVhcnQgQXJyZXN0L2V0aW9sb2d5PC9rZXl3

b3JkPjxrZXl3b3JkPkh1bWFuczwva2V5d29yZD48a2V5d29yZD5Mb25nIFFUIFN5bmRyb21lLypj

bGFzc2lmaWNhdGlvbi8qY29tcGxpY2F0aW9ucy9jb25nZW5pdGFsL3BhdGhvbG9neTwva2V5d29y

ZD48a2V5d29yZD5NYWxlPC9rZXl3b3JkPjxrZXl3b3JkPlByb2dub3Npczwva2V5d29yZD48a2V5

d29yZD5SaXNrIEFzc2Vzc21lbnQ8L2tleXdvcmQ+PGtleXdvcmQ+U3luY29wZS9ldGlvbG9neTwv

a2V5d29yZD48L2tleXdvcmRzPjxkYXRlcz48eWVhcj4yMDA2PC95ZWFyPjxwdWItZGF0ZXM+PGRh

dGU+U2VwIDU8L2RhdGU+PC9wdWItZGF0ZXM+PC9kYXRlcz48aXNibj4xNTU4LTM1OTcgKEVsZWN0

cm9uaWMpPC9pc2JuPjxhY2Nlc3Npb24tbnVtPjE2OTQ5NTAwPC9hY2Nlc3Npb24tbnVtPjx1cmxz

PjxyZWxhdGVkLXVybHM+PHVybD5odHRwOi8vd3d3Lm5jYmkubmxtLm5paC5nb3YvZW50cmV6L3F1

ZXJ5LmZjZ2k/Y21kPVJldHJpZXZlJmFtcDtkYj1QdWJNZWQmYW1wO2RvcHQ9Q2l0YXRpb24mYW1w

O2xpc3RfdWlkcz0xNjk0OTUwMDwvdXJsPjwvcmVsYXRlZC11cmxzPjwvdXJscz48ZWxlY3Ryb25p

Yy1yZXNvdXJjZS1udW0+UzA3MzUtMTA5NygwNikwMTY4Ni1YIFtwaWldJiN4RDsxMC4xMDE2L2ou

amFjYy4yMDA2LjA2LjAzMzwvZWxlY3Ryb25pYy1yZXNvdXJjZS1udW0+PGxhbmd1YWdlPmVuZzwv

bGFuZ3VhZ2U+PC9yZWNvcmQ+PC9DaXRlPjwvRW5kTm90ZQAA

ADDIN EN.CITE PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5Hb2xkZW5iZXJnPC9BdXRob3I+PFllYXI+MjAwNjwvWWVh

cj48UmVjTnVtPjEzMDE8L1JlY051bT48cmVjb3JkPjxyZWMtbnVtYmVyPjEzMDE8L3JlYy1udW1i

ZXI+PGZvcmVpZ24ta2V5cz48a2V5IGFwcD0iRU4iIGRiLWlkPSJmcjB0enBwMnY5eHRwb2V3YTUy

cDBldnFzejJkdnZzdDlzZDAiPjEzMDE8L2tleT48L2ZvcmVpZ24ta2V5cz48cmVmLXR5cGUgbmFt

ZT0iSm91cm5hbCBBcnRpY2xlIj4xNzwvcmVmLXR5cGU+PGNvbnRyaWJ1dG9ycz48YXV0aG9ycz48

YXV0aG9yPkdvbGRlbmJlcmcsIEkuPC9hdXRob3I+PGF1dGhvcj5NYXRoZXcsIEouPC9hdXRob3I+

PGF1dGhvcj5Nb3NzLCBBLiBKLjwvYXV0aG9yPjxhdXRob3I+TWNOaXR0LCBTLjwvYXV0aG9yPjxh

dXRob3I+UGV0ZXJzb24sIEQuIFIuPC9hdXRob3I+PGF1dGhvcj5aYXJlYmEsIFcuPC9hdXRob3I+

PGF1dGhvcj5CZW5ob3JpbiwgSi48L2F1dGhvcj48YXV0aG9yPlpoYW5nLCBMLjwvYXV0aG9yPjxh

dXRob3I+VmluY2VudCwgRy4gTS48L2F1dGhvcj48YXV0aG9yPkFuZHJld3MsIE0uIEwuPC9hdXRo

b3I+PGF1dGhvcj5Sb2JpbnNvbiwgSi4gTC48L2F1dGhvcj48YXV0aG9yPk1vcnJheSwgQi48L2F1

dGhvcj48L2F1dGhvcnM+PC9jb250cmlidXRvcnM+PGF1dGgtYWRkcmVzcz5DYXJkaW9sb2d5IERp

dmlzaW9uLCBEZXBhcnRtZW50IG9mIE1lZGljaW5lLCBVbml2ZXJzaXR5IG9mIFJvY2hlc3RlciBN

ZWRpY2FsIENlbnRlciwgUm9jaGVzdGVyLCBOZXcgWW9yayAxNDY0MiwgVVNBLiBpbGFuLmdvbGRl

bmJlcmdAaGVhcnQucm9jaGVzdGVyLmVkdTwvYXV0aC1hZGRyZXNzPjx0aXRsZXM+PHRpdGxlPkNv

cnJlY3RlZCBRVCB2YXJpYWJpbGl0eSBpbiBzZXJpYWwgZWxlY3Ryb2NhcmRpb2dyYW1zIGluIGxv

bmcgUVQgc3luZHJvbWU6IHRoZSBpbXBvcnRhbmNlIG9mIHRoZSBtYXhpbXVtIGNvcnJlY3RlZCBR

VCBmb3IgcmlzayBzdHJhdGlmaWNhdGlvbjwvdGl0bGU+PHNlY29uZGFyeS10aXRsZT5KIEFtIENv

bGwgQ2FyZGlvbDwvc2Vjb25kYXJ5LXRpdGxlPjwvdGl0bGVzPjxwZXJpb2RpY2FsPjxmdWxsLXRp

dGxlPkogQW0gQ29sbCBDYXJkaW9sPC9mdWxsLXRpdGxlPjwvcGVyaW9kaWNhbD48cGFnZXM+MTA0

Ny01MjwvcGFnZXM+PHZvbHVtZT40ODwvdm9sdW1lPjxudW1iZXI+NTwvbnVtYmVyPjxlZGl0aW9u

PjIwMDYvMDkvMDU8L2VkaXRpb24+PGtleXdvcmRzPjxrZXl3b3JkPkFkb2xlc2NlbnQ8L2tleXdv

cmQ+PGtleXdvcmQ+QWdlIEZhY3RvcnM8L2tleXdvcmQ+PGtleXdvcmQ+Q2hpbGQ8L2tleXdvcmQ+

PGtleXdvcmQ+Q2hpbGQsIFByZXNjaG9vbDwva2V5d29yZD48a2V5d29yZD4qRWxlY3Ryb2NhcmRp

b2dyYXBoeTwva2V5d29yZD48a2V5d29yZD5GZW1hbGU8L2tleXdvcmQ+PGtleXdvcmQ+Rm9sbG93

LVVwIFN0dWRpZXM8L2tleXdvcmQ+PGtleXdvcmQ+SGVhcnQgQXJyZXN0L2V0aW9sb2d5PC9rZXl3

b3JkPjxrZXl3b3JkPkh1bWFuczwva2V5d29yZD48a2V5d29yZD5Mb25nIFFUIFN5bmRyb21lLypj

bGFzc2lmaWNhdGlvbi8qY29tcGxpY2F0aW9ucy9jb25nZW5pdGFsL3BhdGhvbG9neTwva2V5d29y

ZD48a2V5d29yZD5NYWxlPC9rZXl3b3JkPjxrZXl3b3JkPlByb2dub3Npczwva2V5d29yZD48a2V5

d29yZD5SaXNrIEFzc2Vzc21lbnQ8L2tleXdvcmQ+PGtleXdvcmQ+U3luY29wZS9ldGlvbG9neTwv

a2V5d29yZD48L2tleXdvcmRzPjxkYXRlcz48eWVhcj4yMDA2PC95ZWFyPjxwdWItZGF0ZXM+PGRh

dGU+U2VwIDU8L2RhdGU+PC9wdWItZGF0ZXM+PC9kYXRlcz48aXNibj4xNTU4LTM1OTcgKEVsZWN0

cm9uaWMpPC9pc2JuPjxhY2Nlc3Npb24tbnVtPjE2OTQ5NTAwPC9hY2Nlc3Npb24tbnVtPjx1cmxz

PjxyZWxhdGVkLXVybHM+PHVybD5odHRwOi8vd3d3Lm5jYmkubmxtLm5paC5nb3YvZW50cmV6L3F1

ZXJ5LmZjZ2k/Y21kPVJldHJpZXZlJmFtcDtkYj1QdWJNZWQmYW1wO2RvcHQ9Q2l0YXRpb24mYW1w

O2xpc3RfdWlkcz0xNjk0OTUwMDwvdXJsPjwvcmVsYXRlZC11cmxzPjwvdXJscz48ZWxlY3Ryb25p

Yy1yZXNvdXJjZS1udW0+UzA3MzUtMTA5NygwNikwMTY4Ni1YIFtwaWldJiN4RDsxMC4xMDE2L2ou

amFjYy4yMDA2LjA2LjAzMzwvZWxlY3Ryb25pYy1yZXNvdXJjZS1udW0+PGxhbmd1YWdlPmVuZzwv

bGFuZ3VhZ2U+PC9yZWNvcmQ+PC9DaXRlPjwvRW5kTm90ZQAA

ADDIN EN.CITE.DATA 5. Furthermore, in 12-30% of patients with LQTS the resting ECG may have a normal QTc interval at restPEVuZE5vdGU+PENpdGU+PEF1dGhvcj5WaW5jZW50PC9BdXRob3I+PFllYXI+MTk5MjwvWWVhcj48

UmVjTnVtPjUyNzU8L1JlY051bT48cmVjb3JkPjxyZWMtbnVtYmVyPjUyNzU8L3JlYy1udW1iZXI+

PGZvcmVpZ24ta2V5cz48a2V5IGFwcD0nRU4nIGRiLWlkPSdmcjB0enBwMnY5eHRwb2V3YTUycDBl

dnFzejJkdnZzdDlzZDAnPjUyNzU8L2tleT48L2ZvcmVpZ24ta2V5cz48cmVmLXR5cGUgbmFtZT0n

Sm91cm5hbCBBcnRpY2xlJz4xNzwvcmVmLXR5cGU+PGNvbnRyaWJ1dG9ycz48YXV0aG9ycz48YXV0

aG9yPlZpbmNlbnQsIEcuIE0uPC9hdXRob3I+PGF1dGhvcj5UaW1vdGh5LCBLLiBXLjwvYXV0aG9y

PjxhdXRob3I+TGVwcGVydCwgTS48L2F1dGhvcj48YXV0aG9yPktlYXRpbmcsIE0uPC9hdXRob3I+

PC9hdXRob3JzPjwvY29udHJpYnV0b3JzPjxhdXRoLWFkZHJlc3M+RGVwYXJ0bWVudCBvZiBNZWRp

Y2luZSwgTERTIEhvc3BpdGFsLCBTYWx0IExha2UgQ2l0eSwgVVQgODQxNDMuPC9hdXRoLWFkZHJl

c3M+PHRpdGxlcz48dGl0bGU+VGhlIHNwZWN0cnVtIG9mIHN5bXB0b21zIGFuZCBRVCBpbnRlcnZh

bHMgaW4gY2FycmllcnMgb2YgdGhlIGdlbmUgZm9yIHRoZSBsb25nLVFUIHN5bmRyb21lPC90aXRs

ZT48c2Vjb25kYXJ5LXRpdGxlPk4gRW5nbCBKIE1lZDwvc2Vjb25kYXJ5LXRpdGxlPjwvdGl0bGVz

PjxwZXJpb2RpY2FsPjxmdWxsLXRpdGxlPk4gRW5nbCBKIE1lZDwvZnVsbC10aXRsZT48L3Blcmlv

ZGljYWw+PHBhZ2VzPjg0Ni01MjwvcGFnZXM+PHZvbHVtZT4zMjc8L3ZvbHVtZT48bnVtYmVyPjEy

PC9udW1iZXI+PGVkaXRpb24+MTk5Mi8wOS8xNzwvZWRpdGlvbj48a2V5d29yZHM+PGtleXdvcmQ+

QWRvbGVzY2VudDwva2V5d29yZD48a2V5d29yZD5BZHVsdDwva2V5d29yZD48a2V5d29yZD5DaGls

ZDwva2V5d29yZD48a2V5d29yZD5DaGlsZCwgUHJlc2Nob29sPC9rZXl3b3JkPjxrZXl3b3JkPkRl

YXRoLCBTdWRkZW48L2tleXdvcmQ+PGtleXdvcmQ+KkVsZWN0cm9jYXJkaW9ncmFwaHk8L2tleXdv

cmQ+PGtleXdvcmQ+RmVtYWxlPC9rZXl3b3JkPjxrZXl3b3JkPkdlbmV0aWMgTWFya2Vyczwva2V5

d29yZD48a2V5d29yZD4qSGV0ZXJvenlnb3RlPC9rZXl3b3JkPjxrZXl3b3JkPkhldGVyb3p5Z290

ZSBEZXRlY3Rpb24vbWV0aG9kczwva2V5d29yZD48a2V5d29yZD5IdW1hbnM8L2tleXdvcmQ+PGtl

eXdvcmQ+SW5mYW50PC9rZXl3b3JkPjxrZXl3b3JkPkxvbmcgUVQgU3luZHJvbWUvKmdlbmV0aWNz

L3BoeXNpb3BhdGhvbG9neTwva2V5d29yZD48a2V5d29yZD5NYWxlPC9rZXl3b3JkPjxrZXl3b3Jk

PlNlbnNpdGl2aXR5IGFuZCBTcGVjaWZpY2l0eTwva2V5d29yZD48a2V5d29yZD5TeW5jb3BlL2Nv

bXBsaWNhdGlvbnM8L2tleXdvcmQ+PC9rZXl3b3Jkcz48ZGF0ZXM+PHllYXI+MTk5MjwveWVhcj48

cHViLWRhdGVzPjxkYXRlPlNlcCAxNzwvZGF0ZT48L3B1Yi1kYXRlcz48L2RhdGVzPjxpc2JuPjAw

MjgtNDc5MyAoUHJpbnQpPC9pc2JuPjxhY2Nlc3Npb24tbnVtPjE1MDgyNDQ8L2FjY2Vzc2lvbi1u

dW0+PHVybHM+PHJlbGF0ZWQtdXJscz48dXJsPmh0dHA6Ly93d3cubmNiaS5ubG0ubmloLmdvdi9l

bnRyZXovcXVlcnkuZmNnaT9jbWQ9UmV0cmlldmUmYW1wO2RiPVB1Yk1lZCZhbXA7ZG9wdD1DaXRh

dGlvbiZhbXA7bGlzdF91aWRzPTE1MDgyNDQ8L3VybD48L3JlbGF0ZWQtdXJscz48L3VybHM+PGxh

bmd1YWdlPmVuZzwvbGFuZ3VhZ2U+PC9yZWNvcmQ+PC9DaXRlPjxDaXRlPjxBdXRob3I+UHJpb3Jp

PC9BdXRob3I+PFllYXI+MTk5OTwvWWVhcj48UmVjTnVtPjM4NTk8L1JlY051bT48cmVjb3JkPjxy

ZWMtbnVtYmVyPjM4NTk8L3JlYy1udW1iZXI+PGZvcmVpZ24ta2V5cz48a2V5IGFwcD0iRU4iIGRi

LWlkPSJmcjB0enBwMnY5eHRwb2V3YTUycDBldnFzejJkdnZzdDlzZDAiPjM4NTk8L2tleT48L2Zv

cmVpZ24ta2V5cz48cmVmLXR5cGUgbmFtZT0iSm91cm5hbCBBcnRpY2xlIj4xNzwvcmVmLXR5cGU+

PGNvbnRyaWJ1dG9ycz48YXV0aG9ycz48YXV0aG9yPlByaW9yaSwgUy4gRy48L2F1dGhvcj48YXV0

aG9yPk5hcG9saXRhbm8sIEMuPC9hdXRob3I+PGF1dGhvcj5TY2h3YXJ0eiwgUC4gSi48L2F1dGhv

cj48L2F1dGhvcnM+PC9jb250cmlidXRvcnM+PGF1dGgtYWRkcmVzcz5Nb2xlY3VsYXIgQ2FyZGlv

bG9neSBhbmQgRWxlY3Ryb3BoeXNpb2xvZ3kgTGFib3JhdG9yeSwgRm9uZGF6aW9uZSAmcXVvdDtT

YWx2YXRvcmUgTWF1Z2VyaSZxdW90OyBJUkNDUywgUGF2aWEsIEl0YWx5LiBzcHJpb3JpQGZzbS5p

dDwvYXV0aC1hZGRyZXNzPjx0aXRsZXM+PHRpdGxlPkxvdyBwZW5ldHJhbmNlIGluIHRoZSBsb25n

LVFUIHN5bmRyb21lOiBjbGluaWNhbCBpbXBhY3Q8L3RpdGxlPjxzZWNvbmRhcnktdGl0bGU+Q2ly

Y3VsYXRpb248L3NlY29uZGFyeS10aXRsZT48L3RpdGxlcz48cGVyaW9kaWNhbD48ZnVsbC10aXRs

ZT5DaXJjdWxhdGlvbjwvZnVsbC10aXRsZT48L3BlcmlvZGljYWw+PHBhZ2VzPjUyOS0zMzwvcGFn

ZXM+PHZvbHVtZT45OTwvdm9sdW1lPjxudW1iZXI+NDwvbnVtYmVyPjxlZGl0aW9uPjE5OTkvMDIv

MDI8L2VkaXRpb24+PGtleXdvcmRzPjxrZXl3b3JkPkFkb2xlc2NlbnQ8L2tleXdvcmQ+PGtleXdv

cmQ+QWR1bHQ8L2tleXdvcmQ+PGtleXdvcmQ+Q2hpbGQ8L2tleXdvcmQ+PGtleXdvcmQ+RGlhZ25v

c2lzLCBEaWZmZXJlbnRpYWw8L2tleXdvcmQ+PGtleXdvcmQ+RWxlY3Ryb2NhcmRpb2dyYXBoeTwv

a2V5d29yZD48a2V5d29yZD5GZW1hbGU8L2tleXdvcmQ+PGtleXdvcmQ+SHVtYW5zPC9rZXl3b3Jk

PjxrZXl3b3JkPkxvbmcgUVQgU3luZHJvbWUvKmdlbmV0aWNzL3BoeXNpb3BhdGhvbG9neTwva2V5

d29yZD48a2V5d29yZD5NYWxlPC9rZXl3b3JkPjxrZXl3b3JkPk1pZGRsZSBBZ2VkPC9rZXl3b3Jk

PjxrZXl3b3JkPipNdXRhdGlvbjwva2V5d29yZD48a2V5d29yZD5QZWRpZ3JlZTwva2V5d29yZD48

a2V5d29yZD5Qb2x5bW9ycGhpc20sIFNpbmdsZS1TdHJhbmRlZCBDb25mb3JtYXRpb25hbDwva2V5

d29yZD48a2V5d29yZD5TZW5zaXRpdml0eSBhbmQgU3BlY2lmaWNpdHk8L2tleXdvcmQ+PC9rZXl3

b3Jkcz48ZGF0ZXM+PHllYXI+MTk5OTwveWVhcj48cHViLWRhdGVzPjxkYXRlPkZlYiAyPC9kYXRl

PjwvcHViLWRhdGVzPjwvZGF0ZXM+PGlzYm4+MDAwOS03MzIyIChQcmludCk8L2lzYm4+PGFjY2Vz

c2lvbi1udW0+OTkyNzM5OTwvYWNjZXNzaW9uLW51bT48dXJscz48cmVsYXRlZC11cmxzPjx1cmw+

aHR0cDovL3d3dy5uY2JpLm5sbS5uaWguZ292L2VudHJlei9xdWVyeS5mY2dpP2NtZD1SZXRyaWV2

ZSZhbXA7ZGI9UHViTWVkJmFtcDtkb3B0PUNpdGF0aW9uJmFtcDtsaXN0X3VpZHM9OTkyNzM5OTwv

dXJsPjwvcmVsYXRlZC11cmxzPjwvdXJscz48bGFuZ3VhZ2U+ZW5nPC9sYW5ndWFnZT48L3JlY29y

ZD48L0NpdGU+PC9FbmROb3RlPgAAAA==

ADDIN EN.CITE PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5WaW5jZW50PC9BdXRob3I+PFllYXI+MTk5MjwvWWVhcj48

UmVjTnVtPjUyNzU8L1JlY051bT48cmVjb3JkPjxyZWMtbnVtYmVyPjUyNzU8L3JlYy1udW1iZXI+

PGZvcmVpZ24ta2V5cz48a2V5IGFwcD0nRU4nIGRiLWlkPSdmcjB0enBwMnY5eHRwb2V3YTUycDBl

dnFzejJkdnZzdDlzZDAnPjUyNzU8L2tleT48L2ZvcmVpZ24ta2V5cz48cmVmLXR5cGUgbmFtZT0n

Sm91cm5hbCBBcnRpY2xlJz4xNzwvcmVmLXR5cGU+PGNvbnRyaWJ1dG9ycz48YXV0aG9ycz48YXV0

aG9yPlZpbmNlbnQsIEcuIE0uPC9hdXRob3I+PGF1dGhvcj5UaW1vdGh5LCBLLiBXLjwvYXV0aG9y

PjxhdXRob3I+TGVwcGVydCwgTS48L2F1dGhvcj48YXV0aG9yPktlYXRpbmcsIE0uPC9hdXRob3I+

PC9hdXRob3JzPjwvY29udHJpYnV0b3JzPjxhdXRoLWFkZHJlc3M+RGVwYXJ0bWVudCBvZiBNZWRp

Y2luZSwgTERTIEhvc3BpdGFsLCBTYWx0IExha2UgQ2l0eSwgVVQgODQxNDMuPC9hdXRoLWFkZHJl

c3M+PHRpdGxlcz48dGl0bGU+VGhlIHNwZWN0cnVtIG9mIHN5bXB0b21zIGFuZCBRVCBpbnRlcnZh

bHMgaW4gY2FycmllcnMgb2YgdGhlIGdlbmUgZm9yIHRoZSBsb25nLVFUIHN5bmRyb21lPC90aXRs

ZT48c2Vjb25kYXJ5LXRpdGxlPk4gRW5nbCBKIE1lZDwvc2Vjb25kYXJ5LXRpdGxlPjwvdGl0bGVz

PjxwZXJpb2RpY2FsPjxmdWxsLXRpdGxlPk4gRW5nbCBKIE1lZDwvZnVsbC10aXRsZT48L3Blcmlv

ZGljYWw+PHBhZ2VzPjg0Ni01MjwvcGFnZXM+PHZvbHVtZT4zMjc8L3ZvbHVtZT48bnVtYmVyPjEy

PC9udW1iZXI+PGVkaXRpb24+MTk5Mi8wOS8xNzwvZWRpdGlvbj48a2V5d29yZHM+PGtleXdvcmQ+

QWRvbGVzY2VudDwva2V5d29yZD48a2V5d29yZD5BZHVsdDwva2V5d29yZD48a2V5d29yZD5DaGls

ZDwva2V5d29yZD48a2V5d29yZD5DaGlsZCwgUHJlc2Nob29sPC9rZXl3b3JkPjxrZXl3b3JkPkRl

YXRoLCBTdWRkZW48L2tleXdvcmQ+PGtleXdvcmQ+KkVsZWN0cm9jYXJkaW9ncmFwaHk8L2tleXdv

cmQ+PGtleXdvcmQ+RmVtYWxlPC9rZXl3b3JkPjxrZXl3b3JkPkdlbmV0aWMgTWFya2Vyczwva2V5

d29yZD48a2V5d29yZD4qSGV0ZXJvenlnb3RlPC9rZXl3b3JkPjxrZXl3b3JkPkhldGVyb3p5Z290

ZSBEZXRlY3Rpb24vbWV0aG9kczwva2V5d29yZD48a2V5d29yZD5IdW1hbnM8L2tleXdvcmQ+PGtl

eXdvcmQ+SW5mYW50PC9rZXl3b3JkPjxrZXl3b3JkPkxvbmcgUVQgU3luZHJvbWUvKmdlbmV0aWNz

L3BoeXNpb3BhdGhvbG9neTwva2V5d29yZD48a2V5d29yZD5NYWxlPC9rZXl3b3JkPjxrZXl3b3Jk

PlNlbnNpdGl2aXR5IGFuZCBTcGVjaWZpY2l0eTwva2V5d29yZD48a2V5d29yZD5TeW5jb3BlL2Nv

bXBsaWNhdGlvbnM8L2tleXdvcmQ+PC9rZXl3b3Jkcz48ZGF0ZXM+PHllYXI+MTk5MjwveWVhcj48

cHViLWRhdGVzPjxkYXRlPlNlcCAxNzwvZGF0ZT48L3B1Yi1kYXRlcz48L2RhdGVzPjxpc2JuPjAw

MjgtNDc5MyAoUHJpbnQpPC9pc2JuPjxhY2Nlc3Npb24tbnVtPjE1MDgyNDQ8L2FjY2Vzc2lvbi1u

dW0+PHVybHM+PHJlbGF0ZWQtdXJscz48dXJsPmh0dHA6Ly93d3cubmNiaS5ubG0ubmloLmdvdi9l

bnRyZXovcXVlcnkuZmNnaT9jbWQ9UmV0cmlldmUmYW1wO2RiPVB1Yk1lZCZhbXA7ZG9wdD1DaXRh

dGlvbiZhbXA7bGlzdF91aWRzPTE1MDgyNDQ8L3VybD48L3JlbGF0ZWQtdXJscz48L3VybHM+PGxh

bmd1YWdlPmVuZzwvbGFuZ3VhZ2U+PC9yZWNvcmQ+PC9DaXRlPjxDaXRlPjxBdXRob3I+UHJpb3Jp

PC9BdXRob3I+PFllYXI+MTk5OTwvWWVhcj48UmVjTnVtPjM4NTk8L1JlY051bT48cmVjb3JkPjxy

ZWMtbnVtYmVyPjM4NTk8L3JlYy1udW1iZXI+PGZvcmVpZ24ta2V5cz48a2V5IGFwcD0iRU4iIGRi

LWlkPSJmcjB0enBwMnY5eHRwb2V3YTUycDBldnFzejJkdnZzdDlzZDAiPjM4NTk8L2tleT48L2Zv

cmVpZ24ta2V5cz48cmVmLXR5cGUgbmFtZT0iSm91cm5hbCBBcnRpY2xlIj4xNzwvcmVmLXR5cGU+

PGNvbnRyaWJ1dG9ycz48YXV0aG9ycz48YXV0aG9yPlByaW9yaSwgUy4gRy48L2F1dGhvcj48YXV0

aG9yPk5hcG9saXRhbm8sIEMuPC9hdXRob3I+PGF1dGhvcj5TY2h3YXJ0eiwgUC4gSi48L2F1dGhv

cj48L2F1dGhvcnM+PC9jb250cmlidXRvcnM+PGF1dGgtYWRkcmVzcz5Nb2xlY3VsYXIgQ2FyZGlv

bG9neSBhbmQgRWxlY3Ryb3BoeXNpb2xvZ3kgTGFib3JhdG9yeSwgRm9uZGF6aW9uZSAmcXVvdDtT

YWx2YXRvcmUgTWF1Z2VyaSZxdW90OyBJUkNDUywgUGF2aWEsIEl0YWx5LiBzcHJpb3JpQGZzbS5p

dDwvYXV0aC1hZGRyZXNzPjx0aXRsZXM+PHRpdGxlPkxvdyBwZW5ldHJhbmNlIGluIHRoZSBsb25n

LVFUIHN5bmRyb21lOiBjbGluaWNhbCBpbXBhY3Q8L3RpdGxlPjxzZWNvbmRhcnktdGl0bGU+Q2ly

Y3VsYXRpb248L3NlY29uZGFyeS10aXRsZT48L3RpdGxlcz48cGVyaW9kaWNhbD48ZnVsbC10aXRs

ZT5DaXJjdWxhdGlvbjwvZnVsbC10aXRsZT48L3BlcmlvZGljYWw+PHBhZ2VzPjUyOS0zMzwvcGFn

ZXM+PHZvbHVtZT45OTwvdm9sdW1lPjxudW1iZXI+NDwvbnVtYmVyPjxlZGl0aW9uPjE5OTkvMDIv

MDI8L2VkaXRpb24+PGtleXdvcmRzPjxrZXl3b3JkPkFkb2xlc2NlbnQ8L2tleXdvcmQ+PGtleXdv

cmQ+QWR1bHQ8L2tleXdvcmQ+PGtleXdvcmQ+Q2hpbGQ8L2tleXdvcmQ+PGtleXdvcmQ+RGlhZ25v

c2lzLCBEaWZmZXJlbnRpYWw8L2tleXdvcmQ+PGtleXdvcmQ+RWxlY3Ryb2NhcmRpb2dyYXBoeTwv

a2V5d29yZD48a2V5d29yZD5GZW1hbGU8L2tleXdvcmQ+PGtleXdvcmQ+SHVtYW5zPC9rZXl3b3Jk

PjxrZXl3b3JkPkxvbmcgUVQgU3luZHJvbWUvKmdlbmV0aWNzL3BoeXNpb3BhdGhvbG9neTwva2V5

d29yZD48a2V5d29yZD5NYWxlPC9rZXl3b3JkPjxrZXl3b3JkPk1pZGRsZSBBZ2VkPC9rZXl3b3Jk

PjxrZXl3b3JkPipNdXRhdGlvbjwva2V5d29yZD48a2V5d29yZD5QZWRpZ3JlZTwva2V5d29yZD48

a2V5d29yZD5Qb2x5bW9ycGhpc20sIFNpbmdsZS1TdHJhbmRlZCBDb25mb3JtYXRpb25hbDwva2V5

d29yZD48a2V5d29yZD5TZW5zaXRpdml0eSBhbmQgU3BlY2lmaWNpdHk8L2tleXdvcmQ+PC9rZXl3

b3Jkcz48ZGF0ZXM+PHllYXI+MTk5OTwveWVhcj48cHViLWRhdGVzPjxkYXRlPkZlYiAyPC9kYXRl

PjwvcHViLWRhdGVzPjwvZGF0ZXM+PGlzYm4+MDAwOS03MzIyIChQcmludCk8L2lzYm4+PGFjY2Vz

c2lvbi1udW0+OTkyNzM5OTwvYWNjZXNzaW9uLW51bT48dXJscz48cmVsYXRlZC11cmxzPjx1cmw+

aHR0cDovL3d3dy5uY2JpLm5sbS5uaWguZ292L2VudHJlei9xdWVyeS5mY2dpP2NtZD1SZXRyaWV2

ZSZhbXA7ZGI9UHViTWVkJmFtcDtkb3B0PUNpdGF0aW9uJmFtcDtsaXN0X3VpZHM9OTkyNzM5OTwv

dXJsPjwvcmVsYXRlZC11cmxzPjwvdXJscz48bGFuZ3VhZ2U+ZW5nPC9sYW5ndWFnZT48L3JlY29y

ZD48L0NpdGU+PC9FbmROb3RlPgAAAA==

ADDIN EN.CITE.DATA 6, 7. Conversely a proportion of the normal population may have a modestly prolonged QT interval ADDIN EN.CITE <EndNote><Cite><Author>Vetter</Author><Year>2007</Year><RecNum>997</RecNum><record><rec-number>997</rec-number><foreign-keys><key app="EN" db-id="fr0tzpp2v9xtpoewa52p0evqsz2dvvst9sd0">997</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Vetter, V. L.</author></authors></contributors><titles><title>Clues or miscues? How to make the right interpretation and correctly diagnose long-QT syndrome</title><secondary-title>Circulation</secondary-title></titles><periodical><full-title>Circulation</full-title></periodical><pages>2595-8</pages><volume>115</volume><number>20</number><edition>2007/05/23</edition><keywords><keyword>Child</keyword><keyword>Diagnostic Errors/prevention &amp; control</keyword><keyword>Electrocardiography/*methods</keyword><keyword>Genetic Screening</keyword><keyword>Humans</keyword><keyword>Long QT Syndrome/congenital/*diagnosis/genetics</keyword><keyword>Medical History Taking</keyword></keywords><dates><year>2007</year><pub-dates><date>May 22</date></pub-dates></dates><isbn>1524-4539 (Electronic)</isbn><accession-num>17515476</accession-num><urls><related-urls><url> [pii]&#xD;10.1161/CIRCULATIONAHA.107.700195</electronic-resource-num><language>eng</language></record></Cite></EndNote>8. Table 1:. Suggested Bazett Corrected QTc values for diagnosing QT prolongation ADDIN EN.CITE <EndNote><Cite><Author>Goldenberg</Author><Year>2006</Year><RecNum>5288</RecNum><record><rec-number>5288</rec-number><foreign-keys><key app="EN" db-id="fr0tzpp2v9xtpoewa52p0evqsz2dvvst9sd0">5288</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Goldenberg, I.</author><author>Moss, A. J.</author><author>Zareba, W.</author></authors></contributors><auth-address>Cardiology Division, Department of Medicine, University of Rochester Medical Center, Rochester, New York 14642, USA. Ilan.Goldenberg@heart.rochester.edu</auth-address><titles><title>QT interval: how to measure it and what is &quot;normal&quot;</title><secondary-title>J Cardiovasc Electrophysiol</secondary-title></titles><periodical><full-title>J Cardiovasc Electrophysiol</full-title></periodical><pages>333-6</pages><volume>17</volume><number>3</number><edition>2006/04/29</edition><keywords><keyword>Arrhythmias, Cardiac/*physiopathology</keyword><keyword>Electrocardiography/*methods</keyword><keyword>Heart Conduction System/*physiopathology</keyword><keyword>Heart Rate/physiology</keyword><keyword>Humans</keyword><keyword>Reference Values</keyword></keywords><dates><year>2006</year><pub-dates><date>Mar</date></pub-dates></dates><isbn>1045-3873 (Print)</isbn><accession-num>16643414</accession-num><urls><related-urls><url> [pii]&#xD;10.1111/j.1540-8167.2006.00408.x</electronic-resource-num><language>eng</language></record></Cite></EndNote>9QT Interval1-15 YearsAdult MaleAdult FemaleNormal (ms)< 440< 430< 450Borderline (ms)440–460430–450450–470Prolonged (ms)> 460> 450> 470Reversible causes and other conditions must be excluded. In brief, drugs are probably the most common cause. A list of drugs which can prolong the QT interval can be found here: . Electrolyte disturbances must also be considered – particularly hypokalaemia, hypomagnesaemia and hypocalcaemia. Intracranial events may also cause QT prolongation, particularly intracranial haemorrhage. Following resuscitation from cardiac arrest the QT interval may remain prolonged for several months (Moss A J, personal communication). Elite athletes may have modest prolongations in their QT interval without having LQTS ADDIN EN.CITE <EndNote><Cite><Author>Basavarajaiah</Author><Year>2007</Year><RecNum>830</RecNum><record><rec-number>830</rec-number><foreign-keys><key app="EN" db-id="fr0tzpp2v9xtpoewa52p0evqsz2dvvst9sd0">830</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Basavarajaiah, S.</author><author>Wilson, M.</author><author>Whyte, G.</author><author>Shah, A.</author><author>Behr, E.</author><author>Sharma, S.</author></authors></contributors><auth-address>University Hospital Lewisham/King&apos;s College Hospital, London SE5 9RS, UK.</auth-address><titles><title>Prevalence and significance of an isolated long QT interval in elite athletes</title><secondary-title>Eur Heart J</secondary-title></titles><periodical><full-title>Eur Heart J</full-title></periodical><pages>2944-9</pages><volume>28</volume><number>23</number><edition>2007/10/20</edition><keywords><keyword>Adolescent</keyword><keyword>Adult</keyword><keyword>Electrocardiography/methods</keyword><keyword>Exercise Test</keyword><keyword>Female</keyword><keyword>Heart Rate/*physiology</keyword><keyword>Humans</keyword><keyword>Long QT Syndrome/*diagnosis/epidemiology/genetics</keyword><keyword>Male</keyword><keyword>Prevalence</keyword><keyword>Sports/*physiology</keyword></keywords><dates><year>2007</year><pub-dates><date>Dec</date></pub-dates></dates><isbn>0195-668X (Print)</isbn><accession-num>17947213</accession-num><urls><related-urls><url> [pii]&#xD;10.1093/eurheartj/ehm404</electronic-resource-num><language>eng</language></record></Cite></EndNote>10. Patients with dilated or hypertrophic cardiomyopathy may also have a prolonged QT intervalPEVuZE5vdGU+PENpdGU+PEF1dGhvcj5NYXJ0aW48L0F1dGhvcj48WWVhcj4xOTk0PC9ZZWFyPjxS

ZWNOdW0+NDUyMzwvUmVjTnVtPjxyZWNvcmQ+PHJlYy1udW1iZXI+NDUyMzwvcmVjLW51bWJlcj48

Zm9yZWlnbi1rZXlzPjxrZXkgYXBwPSJFTiIgZGItaWQ9ImZyMHR6cHAydjl4dHBvZXdhNTJwMGV2

cXN6MmR2dnN0OXNkMCI+NDUyMzwva2V5PjwvZm9yZWlnbi1rZXlzPjxyZWYtdHlwZSBuYW1lPSJK

b3VybmFsIEFydGljbGUiPjE3PC9yZWYtdHlwZT48Y29udHJpYnV0b3JzPjxhdXRob3JzPjxhdXRo

b3I+TWFydGluLCBBLiBCLjwvYXV0aG9yPjxhdXRob3I+R2Fyc29uLCBBLiwgSnIuPC9hdXRob3I+

PGF1dGhvcj5QZXJyeSwgSi4gQy48L2F1dGhvcj48L2F1dGhvcnM+PC9jb250cmlidXRvcnM+PGF1

dGgtYWRkcmVzcz5MaWxsaWUgRnJhbmsgQWJlcmNyb21iaWUgU2VjdGlvbiBvZiBDYXJkaW9sb2d5

LCBUZXhhcyBDaGlsZHJlbiZhcG9zO3MgSG9zcGl0YWwsIEJheWxvciBDb2xsZWdlIG9mIE1lZGlj

aW5lLCBIb3VzdG9uLjwvYXV0aC1hZGRyZXNzPjx0aXRsZXM+PHRpdGxlPlByb2xvbmdlZCBRVCBp

bnRlcnZhbCBpbiBoeXBlcnRyb3BoaWMgYW5kIGRpbGF0ZWQgY2FyZGlvbXlvcGF0aHkgaW4gY2hp

bGRyZW48L3RpdGxlPjxzZWNvbmRhcnktdGl0bGU+QW0gSGVhcnQgSjwvc2Vjb25kYXJ5LXRpdGxl

PjwvdGl0bGVzPjxwZXJpb2RpY2FsPjxmdWxsLXRpdGxlPkFtIEhlYXJ0IEo8L2Z1bGwtdGl0bGU+

PC9wZXJpb2RpY2FsPjxwYWdlcz42NC03MDwvcGFnZXM+PHZvbHVtZT4xMjc8L3ZvbHVtZT48bnVt

YmVyPjE8L251bWJlcj48ZWRpdGlvbj4xOTk0LzAxLzAxPC9lZGl0aW9uPjxrZXl3b3Jkcz48a2V5

d29yZD5BZG9sZXNjZW50PC9rZXl3b3JkPjxrZXl3b3JkPkFkdWx0PC9rZXl3b3JkPjxrZXl3b3Jk

PkNhcmRpb21lZ2FseS8qY29tcGxpY2F0aW9ucy9waHlzaW9wYXRob2xvZ3k8L2tleXdvcmQ+PGtl

eXdvcmQ+Q2FyZGlvbXlvcGF0aHksIERpbGF0ZWQvKmNvbXBsaWNhdGlvbnMvcGh5c2lvcGF0aG9s

b2d5PC9rZXl3b3JkPjxrZXl3b3JkPkNhcmRpb215b3BhdGh5LCBIeXBlcnRyb3BoaWMvKmNvbXBs

aWNhdGlvbnMvcGh5c2lvcGF0aG9sb2d5PC9rZXl3b3JkPjxrZXl3b3JkPkNhc2UtQ29udHJvbCBT

dHVkaWVzPC9rZXl3b3JkPjxrZXl3b3JkPkNoaWxkPC9rZXl3b3JkPjxrZXl3b3JkPkNoaWxkLCBQ

cmVzY2hvb2w8L2tleXdvcmQ+PGtleXdvcmQ+RWxlY3Ryb2NhcmRpb2dyYXBoeTwva2V5d29yZD48

a2V5d29yZD5IdW1hbnM8L2tleXdvcmQ+PGtleXdvcmQ+SW5mYW50PC9rZXl3b3JkPjxrZXl3b3Jk

PkxvbmcgUVQgU3luZHJvbWUvKmV0aW9sb2d5PC9rZXl3b3JkPjwva2V5d29yZHM+PGRhdGVzPjx5

ZWFyPjE5OTQ8L3llYXI+PHB1Yi1kYXRlcz48ZGF0ZT5KYW48L2RhdGU+PC9wdWItZGF0ZXM+PC9k

YXRlcz48aXNibj4wMDAyLTg3MDMgKFByaW50KTwvaXNibj48YWNjZXNzaW9uLW51bT44MjczNzU3

PC9hY2Nlc3Npb24tbnVtPjx1cmxzPjxyZWxhdGVkLXVybHM+PHVybD5odHRwOi8vd3d3Lm5jYmku

bmxtLm5paC5nb3YvZW50cmV6L3F1ZXJ5LmZjZ2k/Y21kPVJldHJpZXZlJmFtcDtkYj1QdWJNZWQm

YW1wO2RvcHQ9Q2l0YXRpb24mYW1wO2xpc3RfdWlkcz04MjczNzU3PC91cmw+PC9yZWxhdGVkLXVy

bHM+PC91cmxzPjxlbGVjdHJvbmljLXJlc291cmNlLW51bT4wMDAyLTg3MDMoOTQpOTA1MTAtWCBb

cGlpXTwvZWxlY3Ryb25pYy1yZXNvdXJjZS1udW0+PGxhbmd1YWdlPmVuZzwvbGFuZ3VhZ2U+PC9y

ZWNvcmQ+PC9DaXRlPjxDaXRlPjxBdXRob3I+Sm91dmVuPC9BdXRob3I+PFllYXI+MjAwMjwvWWVh

cj48UmVjTnVtPjUyOTI8L1JlY051bT48cmVjb3JkPjxyZWMtbnVtYmVyPjUyOTI8L3JlYy1udW1i

ZXI+PGZvcmVpZ24ta2V5cz48a2V5IGFwcD0iRU4iIGRiLWlkPSJmcjB0enBwMnY5eHRwb2V3YTUy

cDBldnFzejJkdnZzdDlzZDAiPjUyOTI8L2tleT48L2ZvcmVpZ24ta2V5cz48cmVmLXR5cGUgbmFt

ZT0iSm91cm5hbCBBcnRpY2xlIj4xNzwvcmVmLXR5cGU+PGNvbnRyaWJ1dG9ycz48YXV0aG9ycz48

YXV0aG9yPkpvdXZlbiwgWC48L2F1dGhvcj48YXV0aG9yPkhhZ2VnZSwgQS48L2F1dGhvcj48YXV0

aG9yPkNoYXJyb24sIFAuPC9hdXRob3I+PGF1dGhvcj5DYXJyaWVyLCBMLjwvYXV0aG9yPjxhdXRo

b3I+RHVib3VyZywgTy48L2F1dGhvcj48YXV0aG9yPkxhbmdsYXJkLCBKLiBNLjwvYXV0aG9yPjxh

dXRob3I+QWxpYWdhLCBTLjwvYXV0aG9yPjxhdXRob3I+Qm91aG91ciwgSi4gQi48L2F1dGhvcj48

YXV0aG9yPlNjaHdhcnR6LCBLLjwvYXV0aG9yPjxhdXRob3I+RGVzbm9zLCBNLjwvYXV0aG9yPjxh

dXRob3I+S29tYWpkYSwgTS48L2F1dGhvcj48L2F1dGhvcnM+PC9jb250cmlidXRvcnM+PGF1dGgt

YWRkcmVzcz5TZXJ2aWNlIGRlIENhcmRpb2xvZ2llLCBIb3BpdGFsIEV1cm9wZWVuIEdlb3JnZXMg

UG9tcGlkb3UsIFBhcmlzLCBGcmFuY2UuIHhhdmllci5qb3V2ZW5AaG9wLmVncC5hcC1ob3AtcGFy

aXMuZnI8L2F1dGgtYWRkcmVzcz48dGl0bGVzPjx0aXRsZT5SZWxhdGlvbiBiZXR3ZWVuIFFUIGR1

cmF0aW9uIGFuZCBtYXhpbWFsIHdhbGwgdGhpY2tuZXNzIGluIGZhbWlsaWFsIGh5cGVydHJvcGhp

YyBjYXJkaW9teW9wYXRoeTwvdGl0bGU+PHNlY29uZGFyeS10aXRsZT5IZWFydDwvc2Vjb25kYXJ5

LXRpdGxlPjwvdGl0bGVzPjxwZXJpb2RpY2FsPjxmdWxsLXRpdGxlPkhlYXJ0PC9mdWxsLXRpdGxl

PjwvcGVyaW9kaWNhbD48cGFnZXM+MTUzLTc8L3BhZ2VzPjx2b2x1bWU+ODg8L3ZvbHVtZT48bnVt

YmVyPjI8L251bWJlcj48ZWRpdGlvbj4yMDAyLzA3LzE2PC9lZGl0aW9uPjxrZXl3b3Jkcz48a2V5

d29yZD5BZHVsdDwva2V5d29yZD48a2V5d29yZD5BZ2VkPC9rZXl3b3JkPjxrZXl3b3JkPkFnZWQs

IDgwIGFuZCBvdmVyPC9rZXl3b3JkPjxrZXl3b3JkPkNhcmRpb215b3BhdGh5LCBIeXBlcnRyb3Bo

aWMsIEZhbWlsaWFsL2dlbmV0aWNzL3BhdGhvbG9neS8qcGh5c2lvcGF0aG9sb2d5PC9rZXl3b3Jk

PjxrZXl3b3JkPkZlbWFsZTwva2V5d29yZD48a2V5d29yZD5HZW5vdHlwZTwva2V5d29yZD48a2V5

d29yZD5IZWFydCBSYXRlL3BoeXNpb2xvZ3k8L2tleXdvcmQ+PGtleXdvcmQ+SHVtYW5zPC9rZXl3

b3JkPjxrZXl3b3JkPkh5cGVydHJvcGh5LCBMZWZ0IFZlbnRyaWN1bGFyL3BhdGhvbG9neS8qcGh5

c2lvcGF0aG9sb2d5PC9rZXl3b3JkPjxrZXl3b3JkPk1hbGU8L2tleXdvcmQ+PGtleXdvcmQ+TWlk

ZGxlIEFnZWQ8L2tleXdvcmQ+PGtleXdvcmQ+TXV0YXRpb24vcGh5c2lvbG9neTwva2V5d29yZD48

a2V5d29yZD5NeW9zaW4gSGVhdnkgQ2hhaW5zL2dlbmV0aWNzPC9rZXl3b3JkPjxrZXl3b3JkPk9i

c2VydmVyIFZhcmlhdGlvbjwva2V5d29yZD48L2tleXdvcmRzPjxkYXRlcz48eWVhcj4yMDAyPC95

ZWFyPjxwdWItZGF0ZXM+PGRhdGU+QXVnPC9kYXRlPjwvcHViLWRhdGVzPjwvZGF0ZXM+PGlzYm4+

MTQ2OC0yMDFYIChFbGVjdHJvbmljKTwvaXNibj48YWNjZXNzaW9uLW51bT4xMjExNzg0MjwvYWNj

ZXNzaW9uLW51bT48dXJscz48cmVsYXRlZC11cmxzPjx1cmw+aHR0cDovL3B1Ym1lZGNlbnRyYWxj

YW5hZGEuY2EvYXJ0aWNsZXJlbmRlci5jZ2k/dG9vbD1wdWJtZWQmYW1wO3B1Ym1lZGlkPTEyMTE3

ODQyPC91cmw+PHVybD5odHRwOi8vd3d3Lm5jYmkubmxtLm5paC5nb3YvZW50cmV6L3F1ZXJ5LmZj

Z2k/Y21kPVJldHJpZXZlJmFtcDtkYj1QdWJNZWQmYW1wO2RvcHQ9Q2l0YXRpb24mYW1wO2xpc3Rf

dWlkcz0xMjExNzg0MjwvdXJsPjwvcmVsYXRlZC11cmxzPjwvdXJscz48Y3VzdG9tMj4xNzY3MjI0

PC9jdXN0b20yPjxsYW5ndWFnZT5lbmc8L2xhbmd1YWdlPjwvcmVjb3JkPjwvQ2l0ZT48L0VuZE5v

dGU+AAAA

ADDIN EN.CITE PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5NYXJ0aW48L0F1dGhvcj48WWVhcj4xOTk0PC9ZZWFyPjxS

ZWNOdW0+NDUyMzwvUmVjTnVtPjxyZWNvcmQ+PHJlYy1udW1iZXI+NDUyMzwvcmVjLW51bWJlcj48

Zm9yZWlnbi1rZXlzPjxrZXkgYXBwPSJFTiIgZGItaWQ9ImZyMHR6cHAydjl4dHBvZXdhNTJwMGV2

cXN6MmR2dnN0OXNkMCI+NDUyMzwva2V5PjwvZm9yZWlnbi1rZXlzPjxyZWYtdHlwZSBuYW1lPSJK

b3VybmFsIEFydGljbGUiPjE3PC9yZWYtdHlwZT48Y29udHJpYnV0b3JzPjxhdXRob3JzPjxhdXRo

b3I+TWFydGluLCBBLiBCLjwvYXV0aG9yPjxhdXRob3I+R2Fyc29uLCBBLiwgSnIuPC9hdXRob3I+

PGF1dGhvcj5QZXJyeSwgSi4gQy48L2F1dGhvcj48L2F1dGhvcnM+PC9jb250cmlidXRvcnM+PGF1

dGgtYWRkcmVzcz5MaWxsaWUgRnJhbmsgQWJlcmNyb21iaWUgU2VjdGlvbiBvZiBDYXJkaW9sb2d5

LCBUZXhhcyBDaGlsZHJlbiZhcG9zO3MgSG9zcGl0YWwsIEJheWxvciBDb2xsZWdlIG9mIE1lZGlj

aW5lLCBIb3VzdG9uLjwvYXV0aC1hZGRyZXNzPjx0aXRsZXM+PHRpdGxlPlByb2xvbmdlZCBRVCBp

bnRlcnZhbCBpbiBoeXBlcnRyb3BoaWMgYW5kIGRpbGF0ZWQgY2FyZGlvbXlvcGF0aHkgaW4gY2hp

bGRyZW48L3RpdGxlPjxzZWNvbmRhcnktdGl0bGU+QW0gSGVhcnQgSjwvc2Vjb25kYXJ5LXRpdGxl

PjwvdGl0bGVzPjxwZXJpb2RpY2FsPjxmdWxsLXRpdGxlPkFtIEhlYXJ0IEo8L2Z1bGwtdGl0bGU+

PC9wZXJpb2RpY2FsPjxwYWdlcz42NC03MDwvcGFnZXM+PHZvbHVtZT4xMjc8L3ZvbHVtZT48bnVt

YmVyPjE8L251bWJlcj48ZWRpdGlvbj4xOTk0LzAxLzAxPC9lZGl0aW9uPjxrZXl3b3Jkcz48a2V5

d29yZD5BZG9sZXNjZW50PC9rZXl3b3JkPjxrZXl3b3JkPkFkdWx0PC9rZXl3b3JkPjxrZXl3b3Jk

PkNhcmRpb21lZ2FseS8qY29tcGxpY2F0aW9ucy9waHlzaW9wYXRob2xvZ3k8L2tleXdvcmQ+PGtl

eXdvcmQ+Q2FyZGlvbXlvcGF0aHksIERpbGF0ZWQvKmNvbXBsaWNhdGlvbnMvcGh5c2lvcGF0aG9s

b2d5PC9rZXl3b3JkPjxrZXl3b3JkPkNhcmRpb215b3BhdGh5LCBIeXBlcnRyb3BoaWMvKmNvbXBs

aWNhdGlvbnMvcGh5c2lvcGF0aG9sb2d5PC9rZXl3b3JkPjxrZXl3b3JkPkNhc2UtQ29udHJvbCBT

dHVkaWVzPC9rZXl3b3JkPjxrZXl3b3JkPkNoaWxkPC9rZXl3b3JkPjxrZXl3b3JkPkNoaWxkLCBQ

cmVzY2hvb2w8L2tleXdvcmQ+PGtleXdvcmQ+RWxlY3Ryb2NhcmRpb2dyYXBoeTwva2V5d29yZD48

a2V5d29yZD5IdW1hbnM8L2tleXdvcmQ+PGtleXdvcmQ+SW5mYW50PC9rZXl3b3JkPjxrZXl3b3Jk

PkxvbmcgUVQgU3luZHJvbWUvKmV0aW9sb2d5PC9rZXl3b3JkPjwva2V5d29yZHM+PGRhdGVzPjx5

ZWFyPjE5OTQ8L3llYXI+PHB1Yi1kYXRlcz48ZGF0ZT5KYW48L2RhdGU+PC9wdWItZGF0ZXM+PC9k

YXRlcz48aXNibj4wMDAyLTg3MDMgKFByaW50KTwvaXNibj48YWNjZXNzaW9uLW51bT44MjczNzU3

PC9hY2Nlc3Npb24tbnVtPjx1cmxzPjxyZWxhdGVkLXVybHM+PHVybD5odHRwOi8vd3d3Lm5jYmku

bmxtLm5paC5nb3YvZW50cmV6L3F1ZXJ5LmZjZ2k/Y21kPVJldHJpZXZlJmFtcDtkYj1QdWJNZWQm

YW1wO2RvcHQ9Q2l0YXRpb24mYW1wO2xpc3RfdWlkcz04MjczNzU3PC91cmw+PC9yZWxhdGVkLXVy

bHM+PC91cmxzPjxlbGVjdHJvbmljLXJlc291cmNlLW51bT4wMDAyLTg3MDMoOTQpOTA1MTAtWCBb

cGlpXTwvZWxlY3Ryb25pYy1yZXNvdXJjZS1udW0+PGxhbmd1YWdlPmVuZzwvbGFuZ3VhZ2U+PC9y

ZWNvcmQ+PC9DaXRlPjxDaXRlPjxBdXRob3I+Sm91dmVuPC9BdXRob3I+PFllYXI+MjAwMjwvWWVh

cj48UmVjTnVtPjUyOTI8L1JlY051bT48cmVjb3JkPjxyZWMtbnVtYmVyPjUyOTI8L3JlYy1udW1i

ZXI+PGZvcmVpZ24ta2V5cz48a2V5IGFwcD0iRU4iIGRiLWlkPSJmcjB0enBwMnY5eHRwb2V3YTUy

cDBldnFzejJkdnZzdDlzZDAiPjUyOTI8L2tleT48L2ZvcmVpZ24ta2V5cz48cmVmLXR5cGUgbmFt

ZT0iSm91cm5hbCBBcnRpY2xlIj4xNzwvcmVmLXR5cGU+PGNvbnRyaWJ1dG9ycz48YXV0aG9ycz48

YXV0aG9yPkpvdXZlbiwgWC48L2F1dGhvcj48YXV0aG9yPkhhZ2VnZSwgQS48L2F1dGhvcj48YXV0

aG9yPkNoYXJyb24sIFAuPC9hdXRob3I+PGF1dGhvcj5DYXJyaWVyLCBMLjwvYXV0aG9yPjxhdXRo

b3I+RHVib3VyZywgTy48L2F1dGhvcj48YXV0aG9yPkxhbmdsYXJkLCBKLiBNLjwvYXV0aG9yPjxh

dXRob3I+QWxpYWdhLCBTLjwvYXV0aG9yPjxhdXRob3I+Qm91aG91ciwgSi4gQi48L2F1dGhvcj48

YXV0aG9yPlNjaHdhcnR6LCBLLjwvYXV0aG9yPjxhdXRob3I+RGVzbm9zLCBNLjwvYXV0aG9yPjxh

dXRob3I+S29tYWpkYSwgTS48L2F1dGhvcj48L2F1dGhvcnM+PC9jb250cmlidXRvcnM+PGF1dGgt

YWRkcmVzcz5TZXJ2aWNlIGRlIENhcmRpb2xvZ2llLCBIb3BpdGFsIEV1cm9wZWVuIEdlb3JnZXMg

UG9tcGlkb3UsIFBhcmlzLCBGcmFuY2UuIHhhdmllci5qb3V2ZW5AaG9wLmVncC5hcC1ob3AtcGFy

aXMuZnI8L2F1dGgtYWRkcmVzcz48dGl0bGVzPjx0aXRsZT5SZWxhdGlvbiBiZXR3ZWVuIFFUIGR1

cmF0aW9uIGFuZCBtYXhpbWFsIHdhbGwgdGhpY2tuZXNzIGluIGZhbWlsaWFsIGh5cGVydHJvcGhp

YyBjYXJkaW9teW9wYXRoeTwvdGl0bGU+PHNlY29uZGFyeS10aXRsZT5IZWFydDwvc2Vjb25kYXJ5

LXRpdGxlPjwvdGl0bGVzPjxwZXJpb2RpY2FsPjxmdWxsLXRpdGxlPkhlYXJ0PC9mdWxsLXRpdGxl

PjwvcGVyaW9kaWNhbD48cGFnZXM+MTUzLTc8L3BhZ2VzPjx2b2x1bWU+ODg8L3ZvbHVtZT48bnVt

YmVyPjI8L251bWJlcj48ZWRpdGlvbj4yMDAyLzA3LzE2PC9lZGl0aW9uPjxrZXl3b3Jkcz48a2V5

d29yZD5BZHVsdDwva2V5d29yZD48a2V5d29yZD5BZ2VkPC9rZXl3b3JkPjxrZXl3b3JkPkFnZWQs

IDgwIGFuZCBvdmVyPC9rZXl3b3JkPjxrZXl3b3JkPkNhcmRpb215b3BhdGh5LCBIeXBlcnRyb3Bo

aWMsIEZhbWlsaWFsL2dlbmV0aWNzL3BhdGhvbG9neS8qcGh5c2lvcGF0aG9sb2d5PC9rZXl3b3Jk

PjxrZXl3b3JkPkZlbWFsZTwva2V5d29yZD48a2V5d29yZD5HZW5vdHlwZTwva2V5d29yZD48a2V5

d29yZD5IZWFydCBSYXRlL3BoeXNpb2xvZ3k8L2tleXdvcmQ+PGtleXdvcmQ+SHVtYW5zPC9rZXl3

b3JkPjxrZXl3b3JkPkh5cGVydHJvcGh5LCBMZWZ0IFZlbnRyaWN1bGFyL3BhdGhvbG9neS8qcGh5

c2lvcGF0aG9sb2d5PC9rZXl3b3JkPjxrZXl3b3JkPk1hbGU8L2tleXdvcmQ+PGtleXdvcmQ+TWlk

ZGxlIEFnZWQ8L2tleXdvcmQ+PGtleXdvcmQ+TXV0YXRpb24vcGh5c2lvbG9neTwva2V5d29yZD48

a2V5d29yZD5NeW9zaW4gSGVhdnkgQ2hhaW5zL2dlbmV0aWNzPC9rZXl3b3JkPjxrZXl3b3JkPk9i

c2VydmVyIFZhcmlhdGlvbjwva2V5d29yZD48L2tleXdvcmRzPjxkYXRlcz48eWVhcj4yMDAyPC95

ZWFyPjxwdWItZGF0ZXM+PGRhdGU+QXVnPC9kYXRlPjwvcHViLWRhdGVzPjwvZGF0ZXM+PGlzYm4+

MTQ2OC0yMDFYIChFbGVjdHJvbmljKTwvaXNibj48YWNjZXNzaW9uLW51bT4xMjExNzg0MjwvYWNj

ZXNzaW9uLW51bT48dXJscz48cmVsYXRlZC11cmxzPjx1cmw+aHR0cDovL3B1Ym1lZGNlbnRyYWxj

YW5hZGEuY2EvYXJ0aWNsZXJlbmRlci5jZ2k/dG9vbD1wdWJtZWQmYW1wO3B1Ym1lZGlkPTEyMTE3

ODQyPC91cmw+PHVybD5odHRwOi8vd3d3Lm5jYmkubmxtLm5paC5nb3YvZW50cmV6L3F1ZXJ5LmZj

Z2k/Y21kPVJldHJpZXZlJmFtcDtkYj1QdWJNZWQmYW1wO2RvcHQ9Q2l0YXRpb24mYW1wO2xpc3Rf

dWlkcz0xMjExNzg0MjwvdXJsPjwvcmVsYXRlZC11cmxzPjwvdXJscz48Y3VzdG9tMj4xNzY3MjI0

PC9jdXN0b20yPjxsYW5ndWFnZT5lbmc8L2xhbmd1YWdlPjwvcmVjb3JkPjwvQ2l0ZT48L0VuZE5v

dGU+AAAA

ADDIN EN.CITE.DATA 11, 12. In catecholaminergic polymorphic ventricular tachycardia (CPVT) the QT interval may be modestly prolonged ADDIN EN.CITE <EndNote><Cite><Author>Viitasalo</Author><Year>2008</Year><RecNum>5170</RecNum><record><rec-number>5170</rec-number><foreign-keys><key app="EN" db-id="fr0tzpp2v9xtpoewa52p0evqsz2dvvst9sd0">5170</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Viitasalo, M.</author><author>Oikarinen, L.</author><author>Vaananen, H.</author><author>Kontula, K.</author><author>Toivonen, L.</author><author>Swan, H.</author></authors></contributors><titles><title>U-waves and T-wave peak to T-wave end intervals in patients with catecholaminergic polymorphic ventricular tachycardia, effects of beta-blockers</title><secondary-title>Heart Rhythm</secondary-title></titles><periodical><full-title>Heart Rhythm</full-title></periodical><pages>1382-1388</pages><volume>5</volume><number>10</number><dates><year>2008</year></dates><urls></urls></record></Cite></EndNote>13 and, for interest, it should be remembered that LQT7 (Andersen-Tawil syndrome) can present with bidirectional VT ADDIN EN.CITE <EndNote><Cite><Author>Peters</Author><Year>2007</Year><RecNum>5192</RecNum><record><rec-number>5192</rec-number><foreign-keys><key app="EN" db-id="fr0tzpp2v9xtpoewa52p0evqsz2dvvst9sd0">5192</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Peters, S.</author><author>Schulze-Bahr, E.</author><author>Etheridge, S. P.</author><author>Tristani-Firouzi, M.</author></authors></contributors><auth-address>Klinikum Dorothea Christiane Erxleben Quedlinburg, Academic Teaching Hospital of the University Hospital Magdeburg, Innere Medizin II-Kardiologie, Ditfurter Weg 24, 06484 Quedlinburg, Germany. s.peters@klinikum-quedlinburg.de</auth-address><titles><title>Sudden cardiac death in Andersen-Tawil syndrome</title><secondary-title>Europace</secondary-title></titles><periodical><full-title>Europace</full-title></periodical><pages>162-6</pages><volume>9</volume><number>3</number><edition>2007/02/03</edition><keywords><keyword>Andersen Syndrome/*complications/genetics/therapy</keyword><keyword>Death, Sudden, Cardiac/*etiology</keyword><keyword>Defibrillators, Implantable</keyword><keyword>Humans</keyword><keyword>Male</keyword><keyword>Middle Aged</keyword><keyword>Potassium Channels, Inwardly Rectifying/genetics</keyword></keywords><dates><year>2007</year><pub-dates><date>Mar</date></pub-dates></dates><isbn>1099-5129 (Print)</isbn><accession-num>17272325</accession-num><urls><related-urls><url> [pii]&#xD;10.1093/europace/eul188</electronic-resource-num><language>eng</language></record></Cite></EndNote>14, which is typically thought to be characteristic of CPVT. Other conditions to be considered include anorexia nervosa, liver disease and diabetes mellitus PEVuZE5vdGU+PENpdGU+PFllYXI+MjAwNzwvWWVhcj48UmVjTnVtPjUxNjk8L1JlY051bT48cmVj

b3JkPjxyZWMtbnVtYmVyPjUxNjk8L3JlYy1udW1iZXI+PGZvcmVpZ24ta2V5cz48a2V5IGFwcD0i

RU4iIGRiLWlkPSJmcjB0enBwMnY5eHRwb2V3YTUycDBldnFzejJkdnZzdDlzZDAiPjUxNjk8L2tl

eT48L2ZvcmVpZ24ta2V5cz48cmVmLXR5cGUgbmFtZT0iQm9vayBTZWN0aW9uIj41PC9yZWYtdHlw

ZT48Y29udHJpYnV0b3JzPjxzZWNvbmRhcnktYXV0aG9ycz48YXV0aG9yPkEuIEpvaG4gQ2FtbSwg

WWVlIEd1YW4gWWFwIE1hcmVrIE1hbGlrPC9hdXRob3I+PC9zZWNvbmRhcnktYXV0aG9ycz48L2Nv

bnRyaWJ1dG9ycz48YXV0aC1hZGRyZXNzPkRlcGFydG1lbnQgb2YgQ2FyZGlhYyBhbmQgVmFzY3Vs

YXIgU2NpZW5jZXMsIFN0LiBHZW9yZ2UmYXBvcztzIEhvc3BpdGFsIE1lZGljYWwgU2Nob29sLCBM

b25kb24sIFVuaXRlZCBLaW5nZG9tPC9hdXRoLWFkZHJlc3M+PHRpdGxlcz48dGl0bGU+QWNxdWly

ZWQgTG9uZyBRVCBTeW5kcm9tZSBTZWNvbmRhcnkgdG8gTm9uY2FyZGlhYyBDb25kaXRpb25zPC90

aXRsZT48c2Vjb25kYXJ5LXRpdGxlPkFjcXVpcmVkIExvbmcgUVQgU3luZHJvbWUgKEZpcnN0IEVk

aXRpb24pPC9zZWNvbmRhcnktdGl0bGU+PC90aXRsZXM+PHBhZ2VzPjE3MS0xODE8L3BhZ2VzPjxk

YXRlcz48eWVhcj4yMDA3PC95ZWFyPjwvZGF0ZXM+PHVybHM+PHJlbGF0ZWQtdXJscz48dXJsPmh0

dHA6Ly9keC5kb2kub3JnLzEwLjEwMDIvOTc4MDQ3MDk5NDc3MS5jaDExPC91cmw+PC9yZWxhdGVk

LXVybHM+PC91cmxzPjwvcmVjb3JkPjwvQ2l0ZT48Q2l0ZT48QXV0aG9yPkdlbm92ZXNpPC9BdXRo

b3I+PFllYXI+MjAwOTwvWWVhcj48UmVjTnVtPjUzMDA8L1JlY051bT48cmVjb3JkPjxyZWMtbnVt

YmVyPjUzMDA8L3JlYy1udW1iZXI+PGZvcmVpZ24ta2V5cz48a2V5IGFwcD0iRU4iIGRiLWlkPSJm

cjB0enBwMnY5eHRwb2V3YTUycDBldnFzejJkdnZzdDlzZDAiPjUzMDA8L2tleT48L2ZvcmVpZ24t

a2V5cz48cmVmLXR5cGUgbmFtZT0iSm91cm5hbCBBcnRpY2xlIj4xNzwvcmVmLXR5cGU+PGNvbnRy

aWJ1dG9ycz48YXV0aG9ycz48YXV0aG9yPkdlbm92ZXNpLCBTLjwvYXV0aG9yPjxhdXRob3I+UHJh

dGEgUGl6emFsYSwgRC4gTS48L2F1dGhvcj48YXV0aG9yPlBvenppLCBNLjwvYXV0aG9yPjxhdXRo

b3I+UmF0dGksIEwuPC9hdXRob3I+PGF1dGhvcj5NaWxhbmVzZSwgTS48L2F1dGhvcj48YXV0aG9y

PlBpZXJ1enppLCBGLjwvYXV0aG9yPjxhdXRob3I+VmluY2VudGksIEEuPC9hdXRob3I+PGF1dGhv

cj5TdGVsbGEsIEEuPC9hdXRob3I+PGF1dGhvcj5NYW5jaWEsIEcuPC9hdXRob3I+PGF1dGhvcj5T

dHJhbWJhLUJhZGlhbGUsIE0uPC9hdXRob3I+PC9hdXRob3JzPjwvY29udHJpYnV0b3JzPjxhdXRo

LWFkZHJlc3M+RGVwYXJ0bWVudCBvZiBDbGluaWNhbCBNZWRpY2luZSBhbmQgUHJldmVudGlvbiwg

VW5pdmVyc2l0eSBvZiBNaWxhbm8tQmljb2NjYSwgdmlhIENhZG9yZSA0OCwgTW9uemEgMjAwNTIs

IEl0YWx5LiBzaW1vbmV0dGEuZ2Vub3Zlc2lAdW5pbWliLml0PC9hdXRoLWFkZHJlc3M+PHRpdGxl

cz48dGl0bGU+UVQgaW50ZXJ2YWwgcHJvbG9uZ2F0aW9uIGFuZCBkZWNyZWFzZWQgaGVhcnQgcmF0

ZSB2YXJpYWJpbGl0eSBpbiBjaXJyaG90aWMgcGF0aWVudHM6IHJlbGV2YW5jZSBvZiBoZXBhdGlj

IHZlbm91cyBwcmVzc3VyZSBncmFkaWVudCBhbmQgc2VydW0gY2FsY2l1bTwvdGl0bGU+PHNlY29u

ZGFyeS10aXRsZT5DbGluIFNjaSAoTG9uZCk8L3NlY29uZGFyeS10aXRsZT48L3RpdGxlcz48cGVy

aW9kaWNhbD48ZnVsbC10aXRsZT5DbGluIFNjaSAoTG9uZCk8L2Z1bGwtdGl0bGU+PC9wZXJpb2Rp

Y2FsPjxwYWdlcz44NTEtOTwvcGFnZXM+PHZvbHVtZT4xMTY8L3ZvbHVtZT48bnVtYmVyPjEyPC9u

dW1iZXI+PGVkaXRpb24+MjAwOC8xMi8xNzwvZWRpdGlvbj48a2V5d29yZHM+PGtleXdvcmQ+QWR1

bHQ8L2tleXdvcmQ+PGtleXdvcmQ+QWdlZDwva2V5d29yZD48a2V5d29yZD5BbmFseXNpcyBvZiBW

YXJpYW5jZTwva2V5d29yZD48a2V5d29yZD5DYWxjaXVtL21ldGFib2xpc208L2tleXdvcmQ+PGtl

eXdvcmQ+Q2FyZGlvbXlvcGF0aGllcy91bHRyYXNvbm9ncmFwaHk8L2tleXdvcmQ+PGtleXdvcmQ+

RWNob2NhcmRpb2dyYXBoeTwva2V5d29yZD48a2V5d29yZD5FbGVjdHJvY2FyZGlvZ3JhcGh5LCBB

bWJ1bGF0b3J5PC9rZXl3b3JkPjxrZXl3b3JkPkh1bWFuczwva2V5d29yZD48a2V5d29yZD5MaXZl

ciBDaXJyaG9zaXMvYmxvb2QvKmNvbXBsaWNhdGlvbnMvcGh5c2lvcGF0aG9sb2d5PC9rZXl3b3Jk

PjxrZXl3b3JkPkxvbmcgUVQgU3luZHJvbWUvYmxvb2QvKmV0aW9sb2d5L3BoeXNpb3BhdGhvbG9n

eTwva2V5d29yZD48a2V5d29yZD5NYWxlPC9rZXl3b3JkPjxrZXl3b3JkPk1pZGRsZSBBZ2VkPC9r

ZXl3b3JkPjxrZXl3b3JkPlBvcnRhbCBQcmVzc3VyZS9waHlzaW9sb2d5PC9rZXl3b3JkPjwva2V5

d29yZHM+PGRhdGVzPjx5ZWFyPjIwMDk8L3llYXI+PHB1Yi1kYXRlcz48ZGF0ZT5KdWw8L2RhdGU+

PC9wdWItZGF0ZXM+PC9kYXRlcz48aXNibj4xNDcwLTg3MzYgKEVsZWN0cm9uaWMpPC9pc2JuPjxh

Y2Nlc3Npb24tbnVtPjE5MDc2MDU5PC9hY2Nlc3Npb24tbnVtPjx1cmxzPjxyZWxhdGVkLXVybHM+

PHVybD5odHRwOi8vd3d3Lm5jYmkubmxtLm5paC5nb3YvZW50cmV6L3F1ZXJ5LmZjZ2k/Y21kPVJl

dHJpZXZlJmFtcDtkYj1QdWJNZWQmYW1wO2RvcHQ9Q2l0YXRpb24mYW1wO2xpc3RfdWlkcz0xOTA3

NjA1OTwvdXJsPjwvcmVsYXRlZC11cmxzPjwvdXJscz48ZWxlY3Ryb25pYy1yZXNvdXJjZS1udW0+

Q1MyMDA4MDMyNSBbcGlpXSYjeEQ7MTAuMTA0Mi9DUzIwMDgwMzI1PC9lbGVjdHJvbmljLXJlc291

cmNlLW51bT48bGFuZ3VhZ2U+ZW5nPC9sYW5ndWFnZT48L3JlY29yZD48L0NpdGU+PC9FbmROb3Rl

PgAAAA==

ADDIN EN.CITE PEVuZE5vdGU+PENpdGU+PFllYXI+MjAwNzwvWWVhcj48UmVjTnVtPjUxNjk8L1JlY051bT48cmVj

b3JkPjxyZWMtbnVtYmVyPjUxNjk8L3JlYy1udW1iZXI+PGZvcmVpZ24ta2V5cz48a2V5IGFwcD0i

RU4iIGRiLWlkPSJmcjB0enBwMnY5eHRwb2V3YTUycDBldnFzejJkdnZzdDlzZDAiPjUxNjk8L2tl

eT48L2ZvcmVpZ24ta2V5cz48cmVmLXR5cGUgbmFtZT0iQm9vayBTZWN0aW9uIj41PC9yZWYtdHlw

ZT48Y29udHJpYnV0b3JzPjxzZWNvbmRhcnktYXV0aG9ycz48YXV0aG9yPkEuIEpvaG4gQ2FtbSwg

WWVlIEd1YW4gWWFwIE1hcmVrIE1hbGlrPC9hdXRob3I+PC9zZWNvbmRhcnktYXV0aG9ycz48L2Nv

bnRyaWJ1dG9ycz48YXV0aC1hZGRyZXNzPkRlcGFydG1lbnQgb2YgQ2FyZGlhYyBhbmQgVmFzY3Vs

YXIgU2NpZW5jZXMsIFN0LiBHZW9yZ2UmYXBvcztzIEhvc3BpdGFsIE1lZGljYWwgU2Nob29sLCBM

b25kb24sIFVuaXRlZCBLaW5nZG9tPC9hdXRoLWFkZHJlc3M+PHRpdGxlcz48dGl0bGU+QWNxdWly

ZWQgTG9uZyBRVCBTeW5kcm9tZSBTZWNvbmRhcnkgdG8gTm9uY2FyZGlhYyBDb25kaXRpb25zPC90

aXRsZT48c2Vjb25kYXJ5LXRpdGxlPkFjcXVpcmVkIExvbmcgUVQgU3luZHJvbWUgKEZpcnN0IEVk

aXRpb24pPC9zZWNvbmRhcnktdGl0bGU+PC90aXRsZXM+PHBhZ2VzPjE3MS0xODE8L3BhZ2VzPjxk

YXRlcz48eWVhcj4yMDA3PC95ZWFyPjwvZGF0ZXM+PHVybHM+PHJlbGF0ZWQtdXJscz48dXJsPmh0

dHA6Ly9keC5kb2kub3JnLzEwLjEwMDIvOTc4MDQ3MDk5NDc3MS5jaDExPC91cmw+PC9yZWxhdGVk

LXVybHM+PC91cmxzPjwvcmVjb3JkPjwvQ2l0ZT48Q2l0ZT48QXV0aG9yPkdlbm92ZXNpPC9BdXRo

b3I+PFllYXI+MjAwOTwvWWVhcj48UmVjTnVtPjUzMDA8L1JlY051bT48cmVjb3JkPjxyZWMtbnVt

YmVyPjUzMDA8L3JlYy1udW1iZXI+PGZvcmVpZ24ta2V5cz48a2V5IGFwcD0iRU4iIGRiLWlkPSJm

cjB0enBwMnY5eHRwb2V3YTUycDBldnFzejJkdnZzdDlzZDAiPjUzMDA8L2tleT48L2ZvcmVpZ24t

a2V5cz48cmVmLXR5cGUgbmFtZT0iSm91cm5hbCBBcnRpY2xlIj4xNzwvcmVmLXR5cGU+PGNvbnRy

aWJ1dG9ycz48YXV0aG9ycz48YXV0aG9yPkdlbm92ZXNpLCBTLjwvYXV0aG9yPjxhdXRob3I+UHJh

dGEgUGl6emFsYSwgRC4gTS48L2F1dGhvcj48YXV0aG9yPlBvenppLCBNLjwvYXV0aG9yPjxhdXRo

b3I+UmF0dGksIEwuPC9hdXRob3I+PGF1dGhvcj5NaWxhbmVzZSwgTS48L2F1dGhvcj48YXV0aG9y

PlBpZXJ1enppLCBGLjwvYXV0aG9yPjxhdXRob3I+VmluY2VudGksIEEuPC9hdXRob3I+PGF1dGhv

cj5TdGVsbGEsIEEuPC9hdXRob3I+PGF1dGhvcj5NYW5jaWEsIEcuPC9hdXRob3I+PGF1dGhvcj5T

dHJhbWJhLUJhZGlhbGUsIE0uPC9hdXRob3I+PC9hdXRob3JzPjwvY29udHJpYnV0b3JzPjxhdXRo

LWFkZHJlc3M+RGVwYXJ0bWVudCBvZiBDbGluaWNhbCBNZWRpY2luZSBhbmQgUHJldmVudGlvbiwg

VW5pdmVyc2l0eSBvZiBNaWxhbm8tQmljb2NjYSwgdmlhIENhZG9yZSA0OCwgTW9uemEgMjAwNTIs

IEl0YWx5LiBzaW1vbmV0dGEuZ2Vub3Zlc2lAdW5pbWliLml0PC9hdXRoLWFkZHJlc3M+PHRpdGxl

cz48dGl0bGU+UVQgaW50ZXJ2YWwgcHJvbG9uZ2F0aW9uIGFuZCBkZWNyZWFzZWQgaGVhcnQgcmF0

ZSB2YXJpYWJpbGl0eSBpbiBjaXJyaG90aWMgcGF0aWVudHM6IHJlbGV2YW5jZSBvZiBoZXBhdGlj

IHZlbm91cyBwcmVzc3VyZSBncmFkaWVudCBhbmQgc2VydW0gY2FsY2l1bTwvdGl0bGU+PHNlY29u

ZGFyeS10aXRsZT5DbGluIFNjaSAoTG9uZCk8L3NlY29uZGFyeS10aXRsZT48L3RpdGxlcz48cGVy

aW9kaWNhbD48ZnVsbC10aXRsZT5DbGluIFNjaSAoTG9uZCk8L2Z1bGwtdGl0bGU+PC9wZXJpb2Rp

Y2FsPjxwYWdlcz44NTEtOTwvcGFnZXM+PHZvbHVtZT4xMTY8L3ZvbHVtZT48bnVtYmVyPjEyPC9u

dW1iZXI+PGVkaXRpb24+MjAwOC8xMi8xNzwvZWRpdGlvbj48a2V5d29yZHM+PGtleXdvcmQ+QWR1

bHQ8L2tleXdvcmQ+PGtleXdvcmQ+QWdlZDwva2V5d29yZD48a2V5d29yZD5BbmFseXNpcyBvZiBW

YXJpYW5jZTwva2V5d29yZD48a2V5d29yZD5DYWxjaXVtL21ldGFib2xpc208L2tleXdvcmQ+PGtl

eXdvcmQ+Q2FyZGlvbXlvcGF0aGllcy91bHRyYXNvbm9ncmFwaHk8L2tleXdvcmQ+PGtleXdvcmQ+

RWNob2NhcmRpb2dyYXBoeTwva2V5d29yZD48a2V5d29yZD5FbGVjdHJvY2FyZGlvZ3JhcGh5LCBB

bWJ1bGF0b3J5PC9rZXl3b3JkPjxrZXl3b3JkPkh1bWFuczwva2V5d29yZD48a2V5d29yZD5MaXZl

ciBDaXJyaG9zaXMvYmxvb2QvKmNvbXBsaWNhdGlvbnMvcGh5c2lvcGF0aG9sb2d5PC9rZXl3b3Jk

PjxrZXl3b3JkPkxvbmcgUVQgU3luZHJvbWUvYmxvb2QvKmV0aW9sb2d5L3BoeXNpb3BhdGhvbG9n

eTwva2V5d29yZD48a2V5d29yZD5NYWxlPC9rZXl3b3JkPjxrZXl3b3JkPk1pZGRsZSBBZ2VkPC9r

ZXl3b3JkPjxrZXl3b3JkPlBvcnRhbCBQcmVzc3VyZS9waHlzaW9sb2d5PC9rZXl3b3JkPjwva2V5

d29yZHM+PGRhdGVzPjx5ZWFyPjIwMDk8L3llYXI+PHB1Yi1kYXRlcz48ZGF0ZT5KdWw8L2RhdGU+

PC9wdWItZGF0ZXM+PC9kYXRlcz48aXNibj4xNDcwLTg3MzYgKEVsZWN0cm9uaWMpPC9pc2JuPjxh

Y2Nlc3Npb24tbnVtPjE5MDc2MDU5PC9hY2Nlc3Npb24tbnVtPjx1cmxzPjxyZWxhdGVkLXVybHM+

PHVybD5odHRwOi8vd3d3Lm5jYmkubmxtLm5paC5nb3YvZW50cmV6L3F1ZXJ5LmZjZ2k/Y21kPVJl

dHJpZXZlJmFtcDtkYj1QdWJNZWQmYW1wO2RvcHQ9Q2l0YXRpb24mYW1wO2xpc3RfdWlkcz0xOTA3

NjA1OTwvdXJsPjwvcmVsYXRlZC11cmxzPjwvdXJscz48ZWxlY3Ryb25pYy1yZXNvdXJjZS1udW0+

Q1MyMDA4MDMyNSBbcGlpXSYjeEQ7MTAuMTA0Mi9DUzIwMDgwMzI1PC9lbGVjdHJvbmljLXJlc291

cmNlLW51bT48bGFuZ3VhZ2U+ZW5nPC9sYW5ndWFnZT48L3JlY29yZD48L0NpdGU+PC9FbmROb3Rl

PgAAAA==

ADDIN EN.CITE.DATA 15, 16. The QTc is prolonged in patients withcardiac amyloid, but this does not seem to correlate withlife-threatening arrhythmias ADDIN EN.CITE <EndNote><Cite><Author>Parthenakis</Author><Year>1996</Year><RecNum>5424</RecNum><record><rec-number>5424</rec-number><foreign-keys><key app="EN" db-id="fr0tzpp2v9xtpoewa52p0evqsz2dvvst9sd0">5424</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Parthenakis, F. I.</author><author>Vardas, P. E.</author><author>Ralidis, L.</author><author>Dritsas, A.</author><author>Nihoyannopoulos, P.</author></authors></contributors><titles><title>QT Interval in Cardiac Amyloidosis</title><secondary-title>Clin Cardiol</secondary-title></titles><periodical><full-title>Clin Cardiol</full-title></periodical><pages>A 22, 442</pages><volume>19</volume><number>1</number><dates><year>1996</year></dates><urls></urls></record></Cite></EndNote>17.The Schwartz scoring systemThe Schwartz scoring system ADDIN EN.CITE <EndNote><Cite><Author>Schwartz</Author><Year>1993</Year><RecNum>4575</RecNum><record><rec-number>4575</rec-number><foreign-keys><key app="EN" db-id="fr0tzpp2v9xtpoewa52p0evqsz2dvvst9sd0">4575</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Schwartz, P. J.</author><author>Moss, A. J.</author><author>Vincent, G. M.</author><author>Crampton, R. S.</author></authors></contributors><auth-address>Istituto di Clinica Medica II, University of Milan, Italy.</auth-address><titles><title>Diagnostic criteria for the long QT syndrome. An update</title><secondary-title>Circulation</secondary-title></titles><periodical><full-title>Circulation</full-title></periodical><pages>782-4</pages><volume>88</volume><number>2</number><edition>1993/08/01</edition><keywords><keyword>Electrocardiography</keyword><keyword>Humans</keyword><keyword>Long QT Syndrome/*diagnosis</keyword></keywords><dates><year>1993</year><pub-dates><date>Aug</date></pub-dates></dates><isbn>0009-7322 (Print)</isbn><accession-num>8339437</accession-num><urls><related-urls><url> is widely used but does not take into account additional genetic information. It is reproduced below in table 2.Table 2 – Schwartz scoring system for diagnosis of LQTSPointsECG Findings1AQTc2≥ 480ms3460-470ms2450-460ms (in males)1BTorsades de pointes32CT-Wave alternans1DNotched T wave in 3 leads1ELow heart rate for age40.5Clinical HistoryASyncope3With stress2Without stress1BCongenital deafnessFamily History5AFamily members with definite LQTS1BUnexplained sudden cardiac death below age 30 among immediate family members0.5Notes1In the absence of medications or disorders known to affect these ECG features2QTc calculated by Bazett’s formula, where QTc=QT/√RR3Mutually exclusive4Resting heart rate below the 2nd percentile for age ADDIN EN.CITE <EndNote><Cite><Author>Davignon</Author><Year>1980</Year><RecNum>5168</RecNum><record><rec-number>5168</rec-number><foreign-keys><key app="EN" db-id="fr0tzpp2v9xtpoewa52p0evqsz2dvvst9sd0">5168</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Davignon, A.</author><author>Rautaharju, B.</author><author>Boisselle, E.</author><author>Soumis, F.</author><author>Megelas, M.</author><author>Choquette, A.</author></authors></contributors><titles><title>Normal ECG standards for infants and children</title><secondary-title>Paediatric Cardiology</secondary-title></titles><periodical><full-title>Paediatric Cardiology</full-title></periodical><pages>123-130</pages><volume>1</volume><dates><year>1980</year></dates><urls></urls></record></Cite></EndNote>195The same family member cannot be counted in A and BScoringDefinite≥ 4Intermediate probability2-3Low probability≤1HistoryThe history can point to a diagnosis of LQTS. In particular patients should be asked if they have:fainted or become dizzy with exercise, fear or strong emotionsdeveloped palpitations with exercise, fear or strong emotionsbeen treated for a seizure disorder ADDIN EN.CITE <EndNote><Cite><Author>Vetter</Author><Year>2007</Year><RecNum>997</RecNum><record><rec-number>997</rec-number><foreign-keys><key app="EN" db-id="fr0tzpp2v9xtpoewa52p0evqsz2dvvst9sd0">997</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Vetter, V. L.</author></authors></contributors><titles><title>Clues or miscues? How to make the right interpretation and correctly diagnose long-QT syndrome</title><secondary-title>Circulation</secondary-title></titles><periodical><full-title>Circulation</full-title></periodical><pages>2595-8</pages><volume>115</volume><number>20</number><edition>2007/05/23</edition><keywords><keyword>Child</keyword><keyword>Diagnostic Errors/prevention &amp; control</keyword><keyword>Electrocardiography/*methods</keyword><keyword>Genetic Screening</keyword><keyword>Humans</keyword><keyword>Long QT Syndrome/congenital/*diagnosis/genetics</keyword><keyword>Medical History Taking</keyword></keywords><dates><year>2007</year><pub-dates><date>May 22</date></pub-dates></dates><isbn>1524-4539 (Electronic)</isbn><accession-num>17515476</accession-num><urls><related-urls><url> [pii]&#xD;10.1161/CIRCULATIONAHA.107.700195</electronic-resource-num><language>eng</language></record></Cite></EndNote>8Syncope with exercise, particularly swimming tends to point towards a diagnosis of LQT1. Symptoms following emotional stimulation, particularly fear, or strong auditory stimuli seem more common in patients with LQT2. LQT3 syndrome tends to be associated with problems that occur during sleep. Of note LQT1 tends to present before the age of 9, whereas LQT2 and 3 tend to present in teenagers, although cases can remain undiagnosed until adulthood.A full drug history should be taken, including a history of over-the-counter medications and herbal remedies ADDIN EN.CITE <EndNote><Cite><Author>Agarwal</Author><Year>2005</Year><RecNum>5296</RecNum><record><rec-number>5296</rec-number><foreign-keys><key app="EN" db-id="fr0tzpp2v9xtpoewa52p0evqsz2dvvst9sd0">5296</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Agarwal, S. C.</author><author>Crook, J. R.</author><author>Pepper, C. B.</author></authors></contributors><titles><title>Herbal remedies - how safe are they? A case report of polymorphic ventricular tachycardia/ventricular fibrillation induced by herbal medication used for obesity.</title><secondary-title>Int J Cardiol</secondary-title></titles><periodical><full-title>Int J Cardiol</full-title></periodical><pages>260-261</pages><volume>106</volume><number>2</number><dates><year>2005</year></dates><urls></urls></record></Cite></EndNote>20.A history of deafness is important. The Jervell-Lange-Nielsen syndrome – the combination of a long QT interval and congenital deafness was the first of the Long QT syndromes to be described in 1957 ADDIN EN.CITE <EndNote><Cite><Author>Jervell</Author><Year>1957</Year><RecNum>5294</RecNum><record><rec-number>5294</rec-number><foreign-keys><key app="EN" db-id="fr0tzpp2v9xtpoewa52p0evqsz2dvvst9sd0">5294</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Jervell, A.</author><author>Lange-Nielsen, F.</author></authors></contributors><titles><title>Congenital deaf-mutism, functional heart disease with prolongation of the Q-T interval and sudden death</title><secondary-title>Am Heart J</secondary-title></titles><periodical><full-title>Am Heart J</full-title></periodical><pages>59-68</pages><volume>54</volume><number>1</number><edition>1957/07/01</edition><keywords><keyword>*Deafness</keyword><keyword>Heart Diseases/*complications</keyword></keywords><dates><year>1957</year><pub-dates><date>Jul</date></pub-dates></dates><isbn>0002-8703 (Print)</isbn><accession-num>13435203</accession-num><urls><related-urls><url> a comprehensive family history should be taken. A family history of LQTS or unexplained sudden cardiac death raises the likelihood of the index case having LQTS.ExaminationTypically findings on examination will not reveal the diagnosis of LQTS. Some patients may have excessive bradycardia or deafness. Scoliosis and short stature may be seen in LQTS type 7PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5Zb29uPC9BdXRob3I+PFllYXI+MjAwNjwvWWVhcj48UmVj

TnVtPjUzMzA8L1JlY051bT48cmVjb3JkPjxyZWMtbnVtYmVyPjUzMzA8L3JlYy1udW1iZXI+PGZv

cmVpZ24ta2V5cz48a2V5IGFwcD0iRU4iIGRiLWlkPSJmcjB0enBwMnY5eHRwb2V3YTUycDBldnFz

ejJkdnZzdDlzZDAiPjUzMzA8L2tleT48L2ZvcmVpZ24ta2V5cz48cmVmLXR5cGUgbmFtZT0iSm91

cm5hbCBBcnRpY2xlIj4xNzwvcmVmLXR5cGU+PGNvbnRyaWJ1dG9ycz48YXV0aG9ycz48YXV0aG9y

Pllvb24sIEcuPC9hdXRob3I+PGF1dGhvcj5PYmVyb2ksIFMuPC9hdXRob3I+PGF1dGhvcj5Ucmlz

dGFuaS1GaXJvdXppLCBNLjwvYXV0aG9yPjxhdXRob3I+RXRoZXJpZGdlLCBTLiBQLjwvYXV0aG9y

PjxhdXRob3I+UXVpdGFuaWEsIEwuPC9hdXRob3I+PGF1dGhvcj5LcmFtZXIsIEouIEguPC9hdXRo

b3I+PGF1dGhvcj5NaWxsZXIsIEIuIEwuPC9hdXRob3I+PGF1dGhvcj5GdSwgWS4gSC48L2F1dGhv

cj48YXV0aG9yPlB0YWNlaywgTC4gSi48L2F1dGhvcj48L2F1dGhvcnM+PC9jb250cmlidXRvcnM+

PGF1dGgtYWRkcmVzcz5EZXBhcnRtZW50IG9mIFBlZGlhdHJpY3MsIERpdmlzaW9uIG9mIE1lZGlj

YWwgR2VuZXRpY3MsIFVuaXZlcnNpdHkgb2YgQ2FsaWZvcm5pYSwgU2FuIEZyYW5jaXNjbywgQ2Fs

aWZvcm5pYSA5NDE0My0wNzQ4LCBVU0EuIGd5b29uQGl0c2EudWNzZi5lZHU8L2F1dGgtYWRkcmVz

cz48dGl0bGVzPjx0aXRsZT5BbmRlcnNlbi1UYXdpbCBzeW5kcm9tZTogcHJvc3BlY3RpdmUgY29o

b3J0IGFuYWx5c2lzIGFuZCBleHBhbnNpb24gb2YgdGhlIHBoZW5vdHlwZTwvdGl0bGU+PHNlY29u

ZGFyeS10aXRsZT5BbSBKIE1lZCBHZW5ldCBBPC9zZWNvbmRhcnktdGl0bGU+PC90aXRsZXM+PHBl

cmlvZGljYWw+PGZ1bGwtdGl0bGU+QW0gSiBNZWQgR2VuZXQgQTwvZnVsbC10aXRsZT48L3Blcmlv

ZGljYWw+PHBhZ2VzPjMxMi0yMTwvcGFnZXM+PHZvbHVtZT4xNDA8L3ZvbHVtZT48bnVtYmVyPjQ8

L251bWJlcj48ZWRpdGlvbj4yMDA2LzAxLzE5PC9lZGl0aW9uPjxrZXl3b3Jkcz48a2V5d29yZD5B

Ym5vcm1hbGl0aWVzLCBNdWx0aXBsZS9kaWFnbm9zaXMvKmdlbmV0aWNzPC9rZXl3b3JkPjxrZXl3

b3JkPkFkb2xlc2NlbnQ8L2tleXdvcmQ+PGtleXdvcmQ+QWR1bHQ8L2tleXdvcmQ+PGtleXdvcmQ+

QW5kZXJzZW4gU3luZHJvbWUvKmdlbmV0aWNzL3BhdGhvbG9neTwva2V5d29yZD48a2V5d29yZD5B

bnRocm9wb21ldHJ5PC9rZXl3b3JkPjxrZXl3b3JkPkFycmh5dGhtaWFzLCBDYXJkaWFjL2dlbmV0

aWNzPC9rZXl3b3JkPjxrZXl3b3JkPkNoaWxkPC9rZXl3b3JkPjxrZXl3b3JkPkNvaG9ydCBTdHVk

aWVzPC9rZXl3b3JkPjxrZXl3b3JkPkZlbWFsZTwva2V5d29yZD48a2V5d29yZD5HZW5ldGljIFBy

ZWRpc3Bvc2l0aW9uIHRvIERpc2Vhc2U8L2tleXdvcmQ+PGtleXdvcmQ+SHVtYW5zPC9rZXl3b3Jk

PjxrZXl3b3JkPk1hbGU8L2tleXdvcmQ+PGtleXdvcmQ+TXV0YXRpb24vKmdlbmV0aWNzPC9rZXl3

b3JkPjxrZXl3b3JkPk5lcnZvdXMgU3lzdGVtIERpc2Vhc2VzL2dlbmV0aWNzPC9rZXl3b3JkPjxr

ZXl3b3JkPlBlZGlncmVlPC9rZXl3b3JkPjxrZXl3b3JkPlBoZW5vdHlwZTwva2V5d29yZD48a2V5

d29yZD5Qb3Rhc3NpdW0gQ2hhbm5lbHMsIElud2FyZGx5IFJlY3RpZnlpbmcvKmdlbmV0aWNzPC9r

ZXl3b3JkPjxrZXl3b3JkPlByb3NwZWN0aXZlIFN0dWRpZXM8L2tleXdvcmQ+PGtleXdvcmQ+VG9v

dGggQWJub3JtYWxpdGllcy9nZW5ldGljczwva2V5d29yZD48L2tleXdvcmRzPjxkYXRlcz48eWVh

cj4yMDA2PC95ZWFyPjxwdWItZGF0ZXM+PGRhdGU+RmViIDE1PC9kYXRlPjwvcHViLWRhdGVzPjwv

ZGF0ZXM+PGlzYm4+MTU1Mi00ODI1IChQcmludCk8L2lzYm4+PGFjY2Vzc2lvbi1udW0+MTY0MTkx

Mjg8L2FjY2Vzc2lvbi1udW0+PHVybHM+PHJlbGF0ZWQtdXJscz48dXJsPmh0dHA6Ly93d3cubmNi

aS5ubG0ubmloLmdvdi9lbnRyZXovcXVlcnkuZmNnaT9jbWQ9UmV0cmlldmUmYW1wO2RiPVB1Yk1l

ZCZhbXA7ZG9wdD1DaXRhdGlvbiZhbXA7bGlzdF91aWRzPTE2NDE5MTI4PC91cmw+PC9yZWxhdGVk

LXVybHM+PC91cmxzPjxlbGVjdHJvbmljLXJlc291cmNlLW51bT4xMC4xMDAyL2FqbWcuYS4zMTA5

MjwvZWxlY3Ryb25pYy1yZXNvdXJjZS1udW0+PGxhbmd1YWdlPmVuZzwvbGFuZ3VhZ2U+PC9yZWNv

cmQ+PC9DaXRlPjwvRW5kTm90ZT4AAAA=

ADDIN EN.CITE PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5Zb29uPC9BdXRob3I+PFllYXI+MjAwNjwvWWVhcj48UmVj

TnVtPjUzMzA8L1JlY051bT48cmVjb3JkPjxyZWMtbnVtYmVyPjUzMzA8L3JlYy1udW1iZXI+PGZv

cmVpZ24ta2V5cz48a2V5IGFwcD0iRU4iIGRiLWlkPSJmcjB0enBwMnY5eHRwb2V3YTUycDBldnFz

ejJkdnZzdDlzZDAiPjUzMzA8L2tleT48L2ZvcmVpZ24ta2V5cz48cmVmLXR5cGUgbmFtZT0iSm91

cm5hbCBBcnRpY2xlIj4xNzwvcmVmLXR5cGU+PGNvbnRyaWJ1dG9ycz48YXV0aG9ycz48YXV0aG9y

Pllvb24sIEcuPC9hdXRob3I+PGF1dGhvcj5PYmVyb2ksIFMuPC9hdXRob3I+PGF1dGhvcj5Ucmlz

dGFuaS1GaXJvdXppLCBNLjwvYXV0aG9yPjxhdXRob3I+RXRoZXJpZGdlLCBTLiBQLjwvYXV0aG9y

PjxhdXRob3I+UXVpdGFuaWEsIEwuPC9hdXRob3I+PGF1dGhvcj5LcmFtZXIsIEouIEguPC9hdXRo

b3I+PGF1dGhvcj5NaWxsZXIsIEIuIEwuPC9hdXRob3I+PGF1dGhvcj5GdSwgWS4gSC48L2F1dGhv

cj48YXV0aG9yPlB0YWNlaywgTC4gSi48L2F1dGhvcj48L2F1dGhvcnM+PC9jb250cmlidXRvcnM+

PGF1dGgtYWRkcmVzcz5EZXBhcnRtZW50IG9mIFBlZGlhdHJpY3MsIERpdmlzaW9uIG9mIE1lZGlj

YWwgR2VuZXRpY3MsIFVuaXZlcnNpdHkgb2YgQ2FsaWZvcm5pYSwgU2FuIEZyYW5jaXNjbywgQ2Fs

aWZvcm5pYSA5NDE0My0wNzQ4LCBVU0EuIGd5b29uQGl0c2EudWNzZi5lZHU8L2F1dGgtYWRkcmVz

cz48dGl0bGVzPjx0aXRsZT5BbmRlcnNlbi1UYXdpbCBzeW5kcm9tZTogcHJvc3BlY3RpdmUgY29o

b3J0IGFuYWx5c2lzIGFuZCBleHBhbnNpb24gb2YgdGhlIHBoZW5vdHlwZTwvdGl0bGU+PHNlY29u

ZGFyeS10aXRsZT5BbSBKIE1lZCBHZW5ldCBBPC9zZWNvbmRhcnktdGl0bGU+PC90aXRsZXM+PHBl

cmlvZGljYWw+PGZ1bGwtdGl0bGU+QW0gSiBNZWQgR2VuZXQgQTwvZnVsbC10aXRsZT48L3Blcmlv

ZGljYWw+PHBhZ2VzPjMxMi0yMTwvcGFnZXM+PHZvbHVtZT4xNDA8L3ZvbHVtZT48bnVtYmVyPjQ8

L251bWJlcj48ZWRpdGlvbj4yMDA2LzAxLzE5PC9lZGl0aW9uPjxrZXl3b3Jkcz48a2V5d29yZD5B

Ym5vcm1hbGl0aWVzLCBNdWx0aXBsZS9kaWFnbm9zaXMvKmdlbmV0aWNzPC9rZXl3b3JkPjxrZXl3

b3JkPkFkb2xlc2NlbnQ8L2tleXdvcmQ+PGtleXdvcmQ+QWR1bHQ8L2tleXdvcmQ+PGtleXdvcmQ+

QW5kZXJzZW4gU3luZHJvbWUvKmdlbmV0aWNzL3BhdGhvbG9neTwva2V5d29yZD48a2V5d29yZD5B

bnRocm9wb21ldHJ5PC9rZXl3b3JkPjxrZXl3b3JkPkFycmh5dGhtaWFzLCBDYXJkaWFjL2dlbmV0

aWNzPC9rZXl3b3JkPjxrZXl3b3JkPkNoaWxkPC9rZXl3b3JkPjxrZXl3b3JkPkNvaG9ydCBTdHVk

aWVzPC9rZXl3b3JkPjxrZXl3b3JkPkZlbWFsZTwva2V5d29yZD48a2V5d29yZD5HZW5ldGljIFBy

ZWRpc3Bvc2l0aW9uIHRvIERpc2Vhc2U8L2tleXdvcmQ+PGtleXdvcmQ+SHVtYW5zPC9rZXl3b3Jk

PjxrZXl3b3JkPk1hbGU8L2tleXdvcmQ+PGtleXdvcmQ+TXV0YXRpb24vKmdlbmV0aWNzPC9rZXl3

b3JkPjxrZXl3b3JkPk5lcnZvdXMgU3lzdGVtIERpc2Vhc2VzL2dlbmV0aWNzPC9rZXl3b3JkPjxr

ZXl3b3JkPlBlZGlncmVlPC9rZXl3b3JkPjxrZXl3b3JkPlBoZW5vdHlwZTwva2V5d29yZD48a2V5

d29yZD5Qb3Rhc3NpdW0gQ2hhbm5lbHMsIElud2FyZGx5IFJlY3RpZnlpbmcvKmdlbmV0aWNzPC9r

ZXl3b3JkPjxrZXl3b3JkPlByb3NwZWN0aXZlIFN0dWRpZXM8L2tleXdvcmQ+PGtleXdvcmQ+VG9v

dGggQWJub3JtYWxpdGllcy9nZW5ldGljczwva2V5d29yZD48L2tleXdvcmRzPjxkYXRlcz48eWVh

cj4yMDA2PC95ZWFyPjxwdWItZGF0ZXM+PGRhdGU+RmViIDE1PC9kYXRlPjwvcHViLWRhdGVzPjwv

ZGF0ZXM+PGlzYm4+MTU1Mi00ODI1IChQcmludCk8L2lzYm4+PGFjY2Vzc2lvbi1udW0+MTY0MTkx

Mjg8L2FjY2Vzc2lvbi1udW0+PHVybHM+PHJlbGF0ZWQtdXJscz48dXJsPmh0dHA6Ly93d3cubmNi

aS5ubG0ubmloLmdvdi9lbnRyZXovcXVlcnkuZmNnaT9jbWQ9UmV0cmlldmUmYW1wO2RiPVB1Yk1l

ZCZhbXA7ZG9wdD1DaXRhdGlvbiZhbXA7bGlzdF91aWRzPTE2NDE5MTI4PC91cmw+PC9yZWxhdGVk

LXVybHM+PC91cmxzPjxlbGVjdHJvbmljLXJlc291cmNlLW51bT4xMC4xMDAyL2FqbWcuYS4zMTA5

MjwvZWxlY3Ryb25pYy1yZXNvdXJjZS1udW0+PGxhbmd1YWdlPmVuZzwvbGFuZ3VhZ2U+PC9yZWNv

cmQ+PC9DaXRlPjwvRW5kTm90ZT4AAAA=

ADDIN EN.CITE.DATA 22 (Andsersen-Tawil syndrome). LQTS type 8PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5TaWNvdXJpPC9BdXRob3I+PFllYXI+MjAwNzwvWWVhcj48

UmVjTnVtPjU0MTI8L1JlY051bT48cmVjb3JkPjxyZWMtbnVtYmVyPjU0MTI8L3JlYy1udW1iZXI+

PGZvcmVpZ24ta2V5cz48a2V5IGFwcD0iRU4iIGRiLWlkPSJmcjB0enBwMnY5eHRwb2V3YTUycDBl

dnFzejJkdnZzdDlzZDAiPjU0MTI8L2tleT48L2ZvcmVpZ24ta2V5cz48cmVmLXR5cGUgbmFtZT0i

Sm91cm5hbCBBcnRpY2xlIj4xNzwvcmVmLXR5cGU+PGNvbnRyaWJ1dG9ycz48YXV0aG9ycz48YXV0

aG9yPlNpY291cmksIFMuPC9hdXRob3I+PGF1dGhvcj5UaW1vdGh5LCBLLiBXLjwvYXV0aG9yPjxh

dXRob3I+WnlnbXVudCwgQS4gQy48L2F1dGhvcj48YXV0aG9yPkdsYXNzLCBBLjwvYXV0aG9yPjxh

dXRob3I+R29vZHJvdywgUi4gSi48L2F1dGhvcj48YXV0aG9yPkJlbGFyZGluZWxsaSwgTC48L2F1

dGhvcj48YXV0aG9yPkFudHplbGV2aXRjaCwgQy48L2F1dGhvcj48L2F1dGhvcnM+PC9jb250cmli

dXRvcnM+PGF1dGgtYWRkcmVzcz5NYXNvbmljIE1lZGljYWwgUmVzZWFyY2ggTGFib3JhdG9yeSwg

VXRpY2EsIE5ldyBZb3JrIDEzNTAxLTE3ODcsIFVTQS48L2F1dGgtYWRkcmVzcz48dGl0bGVzPjx0

aXRsZT5DZWxsdWxhciBiYXNpcyBmb3IgdGhlIGVsZWN0cm9jYXJkaW9ncmFwaGljIGFuZCBhcnJo

eXRobWljIG1hbmlmZXN0YXRpb25zIG9mIFRpbW90aHkgc3luZHJvbWU6IGVmZmVjdHMgb2YgcmFu

b2xhemluZTwvdGl0bGU+PHNlY29uZGFyeS10aXRsZT5IZWFydCBSaHl0aG08L3NlY29uZGFyeS10

aXRsZT48L3RpdGxlcz48cGVyaW9kaWNhbD48ZnVsbC10aXRsZT5IZWFydCBSaHl0aG08L2Z1bGwt

dGl0bGU+PC9wZXJpb2RpY2FsPjxwYWdlcz42MzgtNDc8L3BhZ2VzPjx2b2x1bWU+NDwvdm9sdW1l

PjxudW1iZXI+NTwvbnVtYmVyPjxlZGl0aW9uPjIwMDcvMDUvMDE8L2VkaXRpb24+PGtleXdvcmRz

PjxrZXl3b3JkPjMtUHlyaWRpbmVjYXJib3h5bGljIGFjaWQsPC9rZXl3b3JkPjxrZXl3b3JkPjEs

NC1kaWh5ZHJvLTIsNi1kaW1ldGh5bC01LW5pdHJvLTQtKDItKHRyaWZsdW9yb21ldGh5bClwaGVu

eWwpLSwgTWV0aHlsPC9rZXl3b3JkPjxrZXl3b3JkPmVzdGVyL2FkdmVyc2UgZWZmZWN0czwva2V5

d29yZD48a2V5d29yZD5BY2V0YW5pbGlkZXMvKnBoYXJtYWNvbG9neTwva2V5d29yZD48a2V5d29y

ZD5BY3Rpb24gUG90ZW50aWFscy9kcnVnIGVmZmVjdHM8L2tleXdvcmQ+PGtleXdvcmQ+QW5hbHlz

aXMgb2YgVmFyaWFuY2U8L2tleXdvcmQ+PGtleXdvcmQ+QW5pbWFsczwva2V5d29yZD48a2V5d29y

ZD5BbnRpLUFycmh5dGhtaWEgQWdlbnRzLypwaGFybWFjb2xvZ3k8L2tleXdvcmQ+PGtleXdvcmQ+

Q2FsY2l1bSBDaGFubmVsIEFnb25pc3RzL2FkdmVyc2UgZWZmZWN0czwva2V5d29yZD48a2V5d29y

ZD5EaXNlYXNlIE1vZGVscywgQW5pbWFsPC9rZXl3b3JkPjxrZXl3b3JkPkRvZ3M8L2tleXdvcmQ+

PGtleXdvcmQ+KkVsZWN0cm9jYXJkaW9ncmFwaHk8L2tleXdvcmQ+PGtleXdvcmQ+RW5kb2NhcmRp

dW0vY3l0b2xvZ3kvZHJ1ZyBlZmZlY3RzL3BoeXNpb3BhdGhvbG9neTwva2V5d29yZD48a2V5d29y

ZD5Fbnp5bWUgSW5oaWJpdG9ycy9waGFybWFjb2xvZ3k8L2tleXdvcmQ+PGtleXdvcmQ+SGVhcnQg

VmVudHJpY2xlcy9jeXRvbG9neS9kcnVnIGVmZmVjdHMvcGh5c2lvcGF0aG9sb2d5PC9rZXl3b3Jk

PjxrZXl3b3JkPkxvbmcgUVQgU3luZHJvbWUvKmRydWcgdGhlcmFweS9ldGlvbG9neS8qcGh5c2lv

cGF0aG9sb2d5PC9rZXl3b3JkPjxrZXl3b3JkPk15b2N5dGVzLCBDYXJkaWFjLypkcnVnIGVmZmVj

dHM8L2tleXdvcmQ+PGtleXdvcmQ+UGF0Y2gtQ2xhbXAgVGVjaG5pcXVlczwva2V5d29yZD48a2V5

d29yZD5QZXJpY2FyZGl1bS9jeXRvbG9neS9kcnVnIGVmZmVjdHMvcGh5c2lvcGF0aG9sb2d5PC9r

ZXl3b3JkPjxrZXl3b3JkPlBpcGVyYXppbmVzLypwaGFybWFjb2xvZ3k8L2tleXdvcmQ+PGtleXdv

cmQ+VGFjaHljYXJkaWEsIFZlbnRyaWN1bGFyL2NoZW1pY2FsbHkgaW5kdWNlZC9kcnVnIHRoZXJh

cHkvcGh5c2lvcGF0aG9sb2d5PC9rZXl3b3JkPjxrZXl3b3JkPlRvcnNhZGVzIGRlIFBvaW50ZXMv

Y2hlbWljYWxseSBpbmR1Y2VkL2RydWcgdGhlcmFweS9waHlzaW9wYXRob2xvZ3k8L2tleXdvcmQ+

PGtleXdvcmQ+VmVudHJpY3VsYXIgUHJlbWF0dXJlIENvbXBsZXhlcy9jaGVtaWNhbGx5IGluZHVj

ZWQvZHJ1Zzwva2V5d29yZD48a2V5d29yZD50aGVyYXB5L3BoeXNpb3BhdGhvbG9neTwva2V5d29y

ZD48L2tleXdvcmRzPjxkYXRlcz48eWVhcj4yMDA3PC95ZWFyPjxwdWItZGF0ZXM+PGRhdGU+TWF5

PC9kYXRlPjwvcHViLWRhdGVzPjwvZGF0ZXM+PGlzYm4+MTU0Ny01MjcxIChQcmludCk8L2lzYm4+

PGFjY2Vzc2lvbi1udW0+MTc0Njc2MzQ8L2FjY2Vzc2lvbi1udW0+PHVybHM+PHJlbGF0ZWQtdXJs

cz48dXJsPmh0dHA6Ly93d3cubmNiaS5ubG0ubmloLmdvdi9lbnRyZXovcXVlcnkuZmNnaT9jbWQ9

UmV0cmlldmUmYW1wO2RiPVB1Yk1lZCZhbXA7ZG9wdD1DaXRhdGlvbiZhbXA7bGlzdF91aWRzPTE3

NDY3NjM0PC91cmw+PC9yZWxhdGVkLXVybHM+PC91cmxzPjxjdXN0b20yPjE5NTE1MzU8L2N1c3Rv

bTI+PGVsZWN0cm9uaWMtcmVzb3VyY2UtbnVtPlMxNTQ3LTUyNzEoMDYpMDIzNTYtMyBbcGlpXSYj

eEQ7MTAuMTAxNi9qLmhydGhtLjIwMDYuMTIuMDQ2PC9lbGVjdHJvbmljLXJlc291cmNlLW51bT48

bGFuZ3VhZ2U+ZW5nPC9sYW5ndWFnZT48L3JlY29yZD48L0NpdGU+PC9FbmROb3RlPgAAAA==

ADDIN EN.CITE PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5TaWNvdXJpPC9BdXRob3I+PFllYXI+MjAwNzwvWWVhcj48

UmVjTnVtPjU0MTI8L1JlY051bT48cmVjb3JkPjxyZWMtbnVtYmVyPjU0MTI8L3JlYy1udW1iZXI+

PGZvcmVpZ24ta2V5cz48a2V5IGFwcD0iRU4iIGRiLWlkPSJmcjB0enBwMnY5eHRwb2V3YTUycDBl

dnFzejJkdnZzdDlzZDAiPjU0MTI8L2tleT48L2ZvcmVpZ24ta2V5cz48cmVmLXR5cGUgbmFtZT0i

Sm91cm5hbCBBcnRpY2xlIj4xNzwvcmVmLXR5cGU+PGNvbnRyaWJ1dG9ycz48YXV0aG9ycz48YXV0

aG9yPlNpY291cmksIFMuPC9hdXRob3I+PGF1dGhvcj5UaW1vdGh5LCBLLiBXLjwvYXV0aG9yPjxh

dXRob3I+WnlnbXVudCwgQS4gQy48L2F1dGhvcj48YXV0aG9yPkdsYXNzLCBBLjwvYXV0aG9yPjxh

dXRob3I+R29vZHJvdywgUi4gSi48L2F1dGhvcj48YXV0aG9yPkJlbGFyZGluZWxsaSwgTC48L2F1

dGhvcj48YXV0aG9yPkFudHplbGV2aXRjaCwgQy48L2F1dGhvcj48L2F1dGhvcnM+PC9jb250cmli

dXRvcnM+PGF1dGgtYWRkcmVzcz5NYXNvbmljIE1lZGljYWwgUmVzZWFyY2ggTGFib3JhdG9yeSwg

VXRpY2EsIE5ldyBZb3JrIDEzNTAxLTE3ODcsIFVTQS48L2F1dGgtYWRkcmVzcz48dGl0bGVzPjx0

aXRsZT5DZWxsdWxhciBiYXNpcyBmb3IgdGhlIGVsZWN0cm9jYXJkaW9ncmFwaGljIGFuZCBhcnJo

eXRobWljIG1hbmlmZXN0YXRpb25zIG9mIFRpbW90aHkgc3luZHJvbWU6IGVmZmVjdHMgb2YgcmFu

b2xhemluZTwvdGl0bGU+PHNlY29uZGFyeS10aXRsZT5IZWFydCBSaHl0aG08L3NlY29uZGFyeS10

aXRsZT48L3RpdGxlcz48cGVyaW9kaWNhbD48ZnVsbC10aXRsZT5IZWFydCBSaHl0aG08L2Z1bGwt

dGl0bGU+PC9wZXJpb2RpY2FsPjxwYWdlcz42MzgtNDc8L3BhZ2VzPjx2b2x1bWU+NDwvdm9sdW1l

PjxudW1iZXI+NTwvbnVtYmVyPjxlZGl0aW9uPjIwMDcvMDUvMDE8L2VkaXRpb24+PGtleXdvcmRz

PjxrZXl3b3JkPjMtUHlyaWRpbmVjYXJib3h5bGljIGFjaWQsPC9rZXl3b3JkPjxrZXl3b3JkPjEs

NC1kaWh5ZHJvLTIsNi1kaW1ldGh5bC01LW5pdHJvLTQtKDItKHRyaWZsdW9yb21ldGh5bClwaGVu

eWwpLSwgTWV0aHlsPC9rZXl3b3JkPjxrZXl3b3JkPmVzdGVyL2FkdmVyc2UgZWZmZWN0czwva2V5

d29yZD48a2V5d29yZD5BY2V0YW5pbGlkZXMvKnBoYXJtYWNvbG9neTwva2V5d29yZD48a2V5d29y

ZD5BY3Rpb24gUG90ZW50aWFscy9kcnVnIGVmZmVjdHM8L2tleXdvcmQ+PGtleXdvcmQ+QW5hbHlz

aXMgb2YgVmFyaWFuY2U8L2tleXdvcmQ+PGtleXdvcmQ+QW5pbWFsczwva2V5d29yZD48a2V5d29y

ZD5BbnRpLUFycmh5dGhtaWEgQWdlbnRzLypwaGFybWFjb2xvZ3k8L2tleXdvcmQ+PGtleXdvcmQ+

Q2FsY2l1bSBDaGFubmVsIEFnb25pc3RzL2FkdmVyc2UgZWZmZWN0czwva2V5d29yZD48a2V5d29y

ZD5EaXNlYXNlIE1vZGVscywgQW5pbWFsPC9rZXl3b3JkPjxrZXl3b3JkPkRvZ3M8L2tleXdvcmQ+

PGtleXdvcmQ+KkVsZWN0cm9jYXJkaW9ncmFwaHk8L2tleXdvcmQ+PGtleXdvcmQ+RW5kb2NhcmRp

dW0vY3l0b2xvZ3kvZHJ1ZyBlZmZlY3RzL3BoeXNpb3BhdGhvbG9neTwva2V5d29yZD48a2V5d29y

ZD5Fbnp5bWUgSW5oaWJpdG9ycy9waGFybWFjb2xvZ3k8L2tleXdvcmQ+PGtleXdvcmQ+SGVhcnQg

VmVudHJpY2xlcy9jeXRvbG9neS9kcnVnIGVmZmVjdHMvcGh5c2lvcGF0aG9sb2d5PC9rZXl3b3Jk

PjxrZXl3b3JkPkxvbmcgUVQgU3luZHJvbWUvKmRydWcgdGhlcmFweS9ldGlvbG9neS8qcGh5c2lv

cGF0aG9sb2d5PC9rZXl3b3JkPjxrZXl3b3JkPk15b2N5dGVzLCBDYXJkaWFjLypkcnVnIGVmZmVj

dHM8L2tleXdvcmQ+PGtleXdvcmQ+UGF0Y2gtQ2xhbXAgVGVjaG5pcXVlczwva2V5d29yZD48a2V5

d29yZD5QZXJpY2FyZGl1bS9jeXRvbG9neS9kcnVnIGVmZmVjdHMvcGh5c2lvcGF0aG9sb2d5PC9r

ZXl3b3JkPjxrZXl3b3JkPlBpcGVyYXppbmVzLypwaGFybWFjb2xvZ3k8L2tleXdvcmQ+PGtleXdv

cmQ+VGFjaHljYXJkaWEsIFZlbnRyaWN1bGFyL2NoZW1pY2FsbHkgaW5kdWNlZC9kcnVnIHRoZXJh

cHkvcGh5c2lvcGF0aG9sb2d5PC9rZXl3b3JkPjxrZXl3b3JkPlRvcnNhZGVzIGRlIFBvaW50ZXMv

Y2hlbWljYWxseSBpbmR1Y2VkL2RydWcgdGhlcmFweS9waHlzaW9wYXRob2xvZ3k8L2tleXdvcmQ+

PGtleXdvcmQ+VmVudHJpY3VsYXIgUHJlbWF0dXJlIENvbXBsZXhlcy9jaGVtaWNhbGx5IGluZHVj

ZWQvZHJ1Zzwva2V5d29yZD48a2V5d29yZD50aGVyYXB5L3BoeXNpb3BhdGhvbG9neTwva2V5d29y

ZD48L2tleXdvcmRzPjxkYXRlcz48eWVhcj4yMDA3PC95ZWFyPjxwdWItZGF0ZXM+PGRhdGU+TWF5

PC9kYXRlPjwvcHViLWRhdGVzPjwvZGF0ZXM+PGlzYm4+MTU0Ny01MjcxIChQcmludCk8L2lzYm4+

PGFjY2Vzc2lvbi1udW0+MTc0Njc2MzQ8L2FjY2Vzc2lvbi1udW0+PHVybHM+PHJlbGF0ZWQtdXJs

cz48dXJsPmh0dHA6Ly93d3cubmNiaS5ubG0ubmloLmdvdi9lbnRyZXovcXVlcnkuZmNnaT9jbWQ9

UmV0cmlldmUmYW1wO2RiPVB1Yk1lZCZhbXA7ZG9wdD1DaXRhdGlvbiZhbXA7bGlzdF91aWRzPTE3

NDY3NjM0PC91cmw+PC9yZWxhdGVkLXVybHM+PC91cmxzPjxjdXN0b20yPjE5NTE1MzU8L2N1c3Rv

bTI+PGVsZWN0cm9uaWMtcmVzb3VyY2UtbnVtPlMxNTQ3LTUyNzEoMDYpMDIzNTYtMyBbcGlpXSYj

eEQ7MTAuMTAxNi9qLmhydGhtLjIwMDYuMTIuMDQ2PC9lbGVjdHJvbmljLXJlc291cmNlLW51bT48

bGFuZ3VhZ2U+ZW5nPC9sYW5ndWFnZT48L3JlY29yZD48L0NpdGU+PC9FbmROb3RlPgAAAA==

ADDIN EN.CITE.DATA 23 (Timothy syndrome) is characterised by co-existent congenital heart disease, cognitive dysfucntion, musculoskeletal problems and immune dysfunction. Examination may suggest an alternative diagnosis – for example a murmur may be heard from underlying hypertrophic cardiomyopathy. Routine investigationsEchocardiographyEchocardiography should be normal in patients with LQTS. It would seem sensible, however, when investigating patients for LQTS to perform echocardiography routinely given the nature of the conditions outlines above which can incidentally prolong the QT interval.Holter monitoringIn patients where the diagnosis of LQTS is in doubt holter monitoring may reveal the diagnosis as the QT interval and QTc are variable over time.Exercise testingIn patients with borderline QT intervals, the dynamic behaviour of the QT interval during exercise testing may suggest the diagnosis. Exercise testing may also suggest an alternate diagnosis, particularly CPVT ADDIN EN.CITE <EndNote><Cite><Author>Horner</Author><Year>2008</Year><RecNum>314</RecNum><record><rec-number>314</rec-number><foreign-keys><key app="EN" db-id="fr0tzpp2v9xtpoewa52p0evqsz2dvvst9sd0">314</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Horner, J. M.</author><author>Ackerman, M. J.</author></authors></contributors><auth-address>Department of Pediatric and Adolescent Medicine, Division of Pediatric Cardiology, Mayo Clinic, Rochester, Minnesota 55905, USA.</auth-address><titles><title>Ventricular ectopy during treadmill exercise stress testing in the evaluation of long QT syndrome</title><secondary-title>Heart Rhythm</secondary-title></titles><periodical><full-title>Heart Rhythm</full-title></periodical><pages>1690-4</pages><volume>5</volume><number>12</number><edition>2008/12/17</edition><keywords><keyword>Diagnosis, Differential</keyword><keyword>*Electrocardiography</keyword><keyword>Exercise Test/*adverse effects</keyword><keyword>Female</keyword><keyword>Follow-Up Studies</keyword><keyword>Heart Rate/physiology</keyword><keyword>Humans</keyword><keyword>Long QT Syndrome/*diagnosis/physiopathology</keyword><keyword>Male</keyword><keyword>Prognosis</keyword><keyword>Retrospective Studies</keyword><keyword>Ventricular Premature Complexes/diagnosis/*etiology/physiopathology</keyword><keyword>Young Adult</keyword></keywords><dates><year>2008</year><pub-dates><date>Dec</date></pub-dates></dates><isbn>1556-3871 (Electronic)</isbn><accession-num>19084807</accession-num><urls><related-urls><url>(08)00869-2 [pii]&#xD;10.1016/j.hrthm.2008.08.038</electronic-resource-num><language>eng</language></record></Cite></EndNote>24. Other investigationsEP testing has not proved useful in risk stratification in patients with LQTS (See ACC/AHA/ESC 2006 guidelines, section 5.3.3.1PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5aaXBlczwvQXV0aG9yPjxZZWFyPjIwMDY8L1llYXI+PFJl

Y051bT41NDI3PC9SZWNOdW0+PHJlY29yZD48cmVjLW51bWJlcj41NDI3PC9yZWMtbnVtYmVyPjxm

b3JlaWduLWtleXM+PGtleSBhcHA9IkVOIiBkYi1pZD0iZnIwdHpwcDJ2OXh0cG9ld2E1MnAwZXZx

c3oyZHZ2c3Q5c2QwIj41NDI3PC9rZXk+PC9mb3JlaWduLWtleXM+PHJlZi10eXBlIG5hbWU9Ikpv

dXJuYWwgQXJ0aWNsZSI+MTc8L3JlZi10eXBlPjxjb250cmlidXRvcnM+PGF1dGhvcnM+PGF1dGhv

cj5aaXBlcywgRC4gUC48L2F1dGhvcj48YXV0aG9yPkNhbW0sIEEuIEouPC9hdXRob3I+PGF1dGhv

cj5Cb3JnZ3JlZmUsIE0uPC9hdXRob3I+PGF1dGhvcj5CdXh0b24sIEEuIEUuPC9hdXRob3I+PGF1

dGhvcj5DaGFpdG1hbiwgQi48L2F1dGhvcj48YXV0aG9yPkZyb21lciwgTS48L2F1dGhvcj48YXV0

aG9yPkdyZWdvcmF0b3MsIEcuPC9hdXRob3I+PGF1dGhvcj5LbGVpbiwgRy48L2F1dGhvcj48YXV0

aG9yPk1vc3MsIEEuIEouPC9hdXRob3I+PGF1dGhvcj5NeWVyYnVyZywgUi4gSi48L2F1dGhvcj48

YXV0aG9yPlByaW9yaSwgUy4gRy48L2F1dGhvcj48YXV0aG9yPlF1aW5vbmVzLCBNLiBBLjwvYXV0

aG9yPjxhdXRob3I+Um9kZW4sIEQuIE0uPC9hdXRob3I+PGF1dGhvcj5TaWxrYSwgTS4gSi48L2F1

dGhvcj48YXV0aG9yPlRyYWN5LCBDLjwvYXV0aG9yPjxhdXRob3I+U21pdGgsIFMuIEMuLCBKci48

L2F1dGhvcj48YXV0aG9yPkphY29icywgQS4gSy48L2F1dGhvcj48YXV0aG9yPkFkYW1zLCBDLiBE

LjwvYXV0aG9yPjxhdXRob3I+QW50bWFuLCBFLiBNLjwvYXV0aG9yPjxhdXRob3I+QW5kZXJzb24s

IEouIEwuPC9hdXRob3I+PGF1dGhvcj5IdW50LCBTLiBBLjwvYXV0aG9yPjxhdXRob3I+SGFscGVy

aW4sIEouIEwuPC9hdXRob3I+PGF1dGhvcj5OaXNoaW11cmEsIFIuPC9hdXRob3I+PGF1dGhvcj5P

cm5hdG8sIEouIFAuPC9hdXRob3I+PGF1dGhvcj5QYWdlLCBSLiBMLjwvYXV0aG9yPjxhdXRob3I+

UmllZ2VsLCBCLjwvYXV0aG9yPjxhdXRob3I+QmxhbmMsIEouIEouPC9hdXRob3I+PGF1dGhvcj5C

dWRhaiwgQS48L2F1dGhvcj48YXV0aG9yPkRlYW4sIFYuPC9hdXRob3I+PGF1dGhvcj5EZWNrZXJz

LCBKLiBXLjwvYXV0aG9yPjxhdXRob3I+RGVzcHJlcywgQy48L2F1dGhvcj48YXV0aG9yPkRpY2tz

dGVpbiwgSy48L2F1dGhvcj48YXV0aG9yPkxla2FraXMsIEouPC9hdXRob3I+PGF1dGhvcj5NY0dy

ZWdvciwgSy48L2F1dGhvcj48YXV0aG9yPk1ldHJhLCBNLjwvYXV0aG9yPjxhdXRob3I+TW9yYWlz

LCBKLjwvYXV0aG9yPjxhdXRob3I+T3N0ZXJzcGV5LCBBLjwvYXV0aG9yPjxhdXRob3I+VGFtYXJn

bywgSi4gTC48L2F1dGhvcj48YXV0aG9yPlphbW9yYW5vLCBKLiBMLjwvYXV0aG9yPjwvYXV0aG9y

cz48L2NvbnRyaWJ1dG9ycz48dGl0bGVzPjx0aXRsZT5BQ0MvQUhBL0VTQyAyMDA2IEd1aWRlbGlu

ZXMgZm9yIE1hbmFnZW1lbnQgb2YgUGF0aWVudHMgV2l0aCBWZW50cmljdWxhciBBcnJoeXRobWlh

cyBhbmQgdGhlIFByZXZlbnRpb24gb2YgU3VkZGVuIENhcmRpYWMgRGVhdGg6IGEgcmVwb3J0IG9m

IHRoZSBBbWVyaWNhbiBDb2xsZWdlIG9mIENhcmRpb2xvZ3kvQW1lcmljYW4gSGVhcnQgQXNzb2Np

YXRpb24gVGFzayBGb3JjZSBhbmQgdGhlIEV1cm9wZWFuIFNvY2lldHkgb2YgQ2FyZGlvbG9neSBD

b21taXR0ZWUgZm9yIFByYWN0aWNlIEd1aWRlbGluZXMgKHdyaXRpbmcgY29tbWl0dGVlIHRvIGRl

dmVsb3AgR3VpZGVsaW5lcyBmb3IgTWFuYWdlbWVudCBvZiBQYXRpZW50cyBXaXRoIFZlbnRyaWN1

bGFyIEFycmh5dGhtaWFzIGFuZCB0aGUgUHJldmVudGlvbiBvZiBTdWRkZW4gQ2FyZGlhYyBEZWF0

aCk6IGRldmVsb3BlZCBpbiBjb2xsYWJvcmF0aW9uIHdpdGggdGhlIEV1cm9wZWFuIEhlYXJ0IFJo

eXRobSBBc3NvY2lhdGlvbiBhbmQgdGhlIEhlYXJ0IFJoeXRobSBTb2NpZXR5PC90aXRsZT48c2Vj

b25kYXJ5LXRpdGxlPkNpcmN1bGF0aW9uPC9zZWNvbmRhcnktdGl0bGU+PC90aXRsZXM+PHBlcmlv

ZGljYWw+PGZ1bGwtdGl0bGU+Q2lyY3VsYXRpb248L2Z1bGwtdGl0bGU+PC9wZXJpb2RpY2FsPjxw

YWdlcz5lMzg1LTQ4NDwvcGFnZXM+PHZvbHVtZT4xMTQ8L3ZvbHVtZT48bnVtYmVyPjEwPC9udW1i

ZXI+PGtleXdvcmRzPjxrZXl3b3JkPkFtZXJpY2FuIEhlYXJ0IEFzc29jaWF0aW9uPC9rZXl3b3Jk

PjxrZXl3b3JkPkFycmh5dGhtaWEvKnRoZXJhcHk8L2tleXdvcmQ+PGtleXdvcmQ+RGVhdGgsIFN1

ZGRlbiwgQ2FyZGlhYy8qcHJldmVudGlvbiAmYW1wOyBjb250cm9sPC9rZXl3b3JkPjxrZXl3b3Jk

PkV1cm9wZTwva2V5d29yZD48a2V5d29yZD5IdW1hbnM8L2tleXdvcmQ+PGtleXdvcmQ+UXVhbGl0

eSBBc3N1cmFuY2UsIEhlYWx0aCBDYXJlPC9rZXl3b3JkPjxrZXl3b3JkPlNvY2lldGllcywgTWVk

aWNhbDwva2V5d29yZD48a2V5d29yZD5WZW50cmljdWxhciBEeXNmdW5jdGlvbi8qdGhlcmFweTwv

a2V5d29yZD48L2tleXdvcmRzPjxkYXRlcz48eWVhcj4yMDA2PC95ZWFyPjwvZGF0ZXM+PGFjY2Vz

c2lvbi1udW0+MTY5MzU5OTU8L2FjY2Vzc2lvbi1udW0+PHVybHM+PHJlbGF0ZWQtdXJscz48dXJs

Pmh0dHA6Ly93d3cubmNiaS5ubG0ubmloLmdvdi9lbnRyZXovcXVlcnkuZmNnaT9jbWQ9UmV0cmll

dmUmYW1wO2RiPVB1Yk1lZCZhbXA7ZG9wdD1DaXRhdGlvbiZhbXA7bGlzdF91aWRzPTE2OTM1OTk1

PC91cmw+PC9yZWxhdGVkLXVybHM+PC91cmxzPjwvcmVjb3JkPjwvQ2l0ZT48L0VuZE5vdGU+AAA=

ADDIN EN.CITE PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5aaXBlczwvQXV0aG9yPjxZZWFyPjIwMDY8L1llYXI+PFJl

Y051bT41NDI3PC9SZWNOdW0+PHJlY29yZD48cmVjLW51bWJlcj41NDI3PC9yZWMtbnVtYmVyPjxm

b3JlaWduLWtleXM+PGtleSBhcHA9IkVOIiBkYi1pZD0iZnIwdHpwcDJ2OXh0cG9ld2E1MnAwZXZx

c3oyZHZ2c3Q5c2QwIj41NDI3PC9rZXk+PC9mb3JlaWduLWtleXM+PHJlZi10eXBlIG5hbWU9Ikpv

dXJuYWwgQXJ0aWNsZSI+MTc8L3JlZi10eXBlPjxjb250cmlidXRvcnM+PGF1dGhvcnM+PGF1dGhv

cj5aaXBlcywgRC4gUC48L2F1dGhvcj48YXV0aG9yPkNhbW0sIEEuIEouPC9hdXRob3I+PGF1dGhv

cj5Cb3JnZ3JlZmUsIE0uPC9hdXRob3I+PGF1dGhvcj5CdXh0b24sIEEuIEUuPC9hdXRob3I+PGF1

dGhvcj5DaGFpdG1hbiwgQi48L2F1dGhvcj48YXV0aG9yPkZyb21lciwgTS48L2F1dGhvcj48YXV0

aG9yPkdyZWdvcmF0b3MsIEcuPC9hdXRob3I+PGF1dGhvcj5LbGVpbiwgRy48L2F1dGhvcj48YXV0

aG9yPk1vc3MsIEEuIEouPC9hdXRob3I+PGF1dGhvcj5NeWVyYnVyZywgUi4gSi48L2F1dGhvcj48

YXV0aG9yPlByaW9yaSwgUy4gRy48L2F1dGhvcj48YXV0aG9yPlF1aW5vbmVzLCBNLiBBLjwvYXV0

aG9yPjxhdXRob3I+Um9kZW4sIEQuIE0uPC9hdXRob3I+PGF1dGhvcj5TaWxrYSwgTS4gSi48L2F1

dGhvcj48YXV0aG9yPlRyYWN5LCBDLjwvYXV0aG9yPjxhdXRob3I+U21pdGgsIFMuIEMuLCBKci48

L2F1dGhvcj48YXV0aG9yPkphY29icywgQS4gSy48L2F1dGhvcj48YXV0aG9yPkFkYW1zLCBDLiBE

LjwvYXV0aG9yPjxhdXRob3I+QW50bWFuLCBFLiBNLjwvYXV0aG9yPjxhdXRob3I+QW5kZXJzb24s

IEouIEwuPC9hdXRob3I+PGF1dGhvcj5IdW50LCBTLiBBLjwvYXV0aG9yPjxhdXRob3I+SGFscGVy

aW4sIEouIEwuPC9hdXRob3I+PGF1dGhvcj5OaXNoaW11cmEsIFIuPC9hdXRob3I+PGF1dGhvcj5P

cm5hdG8sIEouIFAuPC9hdXRob3I+PGF1dGhvcj5QYWdlLCBSLiBMLjwvYXV0aG9yPjxhdXRob3I+

UmllZ2VsLCBCLjwvYXV0aG9yPjxhdXRob3I+QmxhbmMsIEouIEouPC9hdXRob3I+PGF1dGhvcj5C

dWRhaiwgQS48L2F1dGhvcj48YXV0aG9yPkRlYW4sIFYuPC9hdXRob3I+PGF1dGhvcj5EZWNrZXJz

LCBKLiBXLjwvYXV0aG9yPjxhdXRob3I+RGVzcHJlcywgQy48L2F1dGhvcj48YXV0aG9yPkRpY2tz

dGVpbiwgSy48L2F1dGhvcj48YXV0aG9yPkxla2FraXMsIEouPC9hdXRob3I+PGF1dGhvcj5NY0dy

ZWdvciwgSy48L2F1dGhvcj48YXV0aG9yPk1ldHJhLCBNLjwvYXV0aG9yPjxhdXRob3I+TW9yYWlz

LCBKLjwvYXV0aG9yPjxhdXRob3I+T3N0ZXJzcGV5LCBBLjwvYXV0aG9yPjxhdXRob3I+VGFtYXJn

bywgSi4gTC48L2F1dGhvcj48YXV0aG9yPlphbW9yYW5vLCBKLiBMLjwvYXV0aG9yPjwvYXV0aG9y

cz48L2NvbnRyaWJ1dG9ycz48dGl0bGVzPjx0aXRsZT5BQ0MvQUhBL0VTQyAyMDA2IEd1aWRlbGlu

ZXMgZm9yIE1hbmFnZW1lbnQgb2YgUGF0aWVudHMgV2l0aCBWZW50cmljdWxhciBBcnJoeXRobWlh

cyBhbmQgdGhlIFByZXZlbnRpb24gb2YgU3VkZGVuIENhcmRpYWMgRGVhdGg6IGEgcmVwb3J0IG9m

IHRoZSBBbWVyaWNhbiBDb2xsZWdlIG9mIENhcmRpb2xvZ3kvQW1lcmljYW4gSGVhcnQgQXNzb2Np

YXRpb24gVGFzayBGb3JjZSBhbmQgdGhlIEV1cm9wZWFuIFNvY2lldHkgb2YgQ2FyZGlvbG9neSBD

b21taXR0ZWUgZm9yIFByYWN0aWNlIEd1aWRlbGluZXMgKHdyaXRpbmcgY29tbWl0dGVlIHRvIGRl

dmVsb3AgR3VpZGVsaW5lcyBmb3IgTWFuYWdlbWVudCBvZiBQYXRpZW50cyBXaXRoIFZlbnRyaWN1

bGFyIEFycmh5dGhtaWFzIGFuZCB0aGUgUHJldmVudGlvbiBvZiBTdWRkZW4gQ2FyZGlhYyBEZWF0

aCk6IGRldmVsb3BlZCBpbiBjb2xsYWJvcmF0aW9uIHdpdGggdGhlIEV1cm9wZWFuIEhlYXJ0IFJo

eXRobSBBc3NvY2lhdGlvbiBhbmQgdGhlIEhlYXJ0IFJoeXRobSBTb2NpZXR5PC90aXRsZT48c2Vj

b25kYXJ5LXRpdGxlPkNpcmN1bGF0aW9uPC9zZWNvbmRhcnktdGl0bGU+PC90aXRsZXM+PHBlcmlv

ZGljYWw+PGZ1bGwtdGl0bGU+Q2lyY3VsYXRpb248L2Z1bGwtdGl0bGU+PC9wZXJpb2RpY2FsPjxw

YWdlcz5lMzg1LTQ4NDwvcGFnZXM+PHZvbHVtZT4xMTQ8L3ZvbHVtZT48bnVtYmVyPjEwPC9udW1i

ZXI+PGtleXdvcmRzPjxrZXl3b3JkPkFtZXJpY2FuIEhlYXJ0IEFzc29jaWF0aW9uPC9rZXl3b3Jk

PjxrZXl3b3JkPkFycmh5dGhtaWEvKnRoZXJhcHk8L2tleXdvcmQ+PGtleXdvcmQ+RGVhdGgsIFN1

ZGRlbiwgQ2FyZGlhYy8qcHJldmVudGlvbiAmYW1wOyBjb250cm9sPC9rZXl3b3JkPjxrZXl3b3Jk

PkV1cm9wZTwva2V5d29yZD48a2V5d29yZD5IdW1hbnM8L2tleXdvcmQ+PGtleXdvcmQ+UXVhbGl0

eSBBc3N1cmFuY2UsIEhlYWx0aCBDYXJlPC9rZXl3b3JkPjxrZXl3b3JkPlNvY2lldGllcywgTWVk

aWNhbDwva2V5d29yZD48a2V5d29yZD5WZW50cmljdWxhciBEeXNmdW5jdGlvbi8qdGhlcmFweTwv

a2V5d29yZD48L2tleXdvcmRzPjxkYXRlcz48eWVhcj4yMDA2PC95ZWFyPjwvZGF0ZXM+PGFjY2Vz

c2lvbi1udW0+MTY5MzU5OTU8L2FjY2Vzc2lvbi1udW0+PHVybHM+PHJlbGF0ZWQtdXJscz48dXJs

Pmh0dHA6Ly93d3cubmNiaS5ubG0ubmloLmdvdi9lbnRyZXovcXVlcnkuZmNnaT9jbWQ9UmV0cmll

dmUmYW1wO2RiPVB1Yk1lZCZhbXA7ZG9wdD1DaXRhdGlvbiZhbXA7bGlzdF91aWRzPTE2OTM1OTk1

PC91cmw+PC9yZWxhdGVkLXVybHM+PC91cmxzPjwvcmVjb3JkPjwvQ2l0ZT48L0VuZE5vdGU+AAA=

ADDIN EN.CITE.DATA 25). Genetic testingLQTS is inherited in an autosomal dominant fashion.Genetic testing is of value in LQTS, particularly as the QT interval may appear normal. In patients with LQTS genetic testing may be abnormal in up to ? of patients. It can be used to confirm the diagnosis of LQTS. It may also suggest appropriate therapy and it is beginning to help with risk stratification in quite a sophisticated way. It may facilitate the screening of relatives. If genetic testing for LQTS is negative it may be reasonable to screen for RyR2 mutations which are found in CPVT. Genetic testing for LQTS is recommended as part of a genetic autopsy.It is important to remember that clinical screening alone cannot identify relatives of patients with LQTS who carry identical genetic mutations. Part of this may be due to erroneous computer-generated ECG diagnostic interpretation. The genetics of LQTS are complex, and becoming increasingly so, and are summarised in table 3.LQT1, 2 and 3 comprise the majority of clinical cases.Importantly around 10% of patients have more than one mutation. It has been suggested that because double heterozygosity appears to be more common than expected, molecular diagnosis should be performed on all LQTS-related genes, notwithstanding the identification of a single mutation.Table 3. The genetics of LQTS LINK Excel.Sheet.12 "C:\\Users\\Mark\\Desktop\\LQT syndrome\\Genetics of LQTs.xlsx" Acr4E73!R1C1:R13C5 \a \f 5 \h \* MERGEFORMAT Type of LQTS Chromosomal LocusMutated GeneIon Current Affected PrevalenceLQT1 (Romano-Ward syndrome)11p15.5 KCNQ1Potassium (IKs) 42%LQT2 7q35-36 KCNH2 Potassium (IKr) 45%LQT3 3p21-24 SCN5A Sodium (INa) 8%LQT4 4q25-27 ANK2Sodium, potassium and calcium RareLQT5 (Jervell and Lange-Nielsen syndrome)21q22.1-22.2 KCNE1Potassium (IKs) 3%LQT6 21q22.1-22.2 KNCE2 Potassium (IKr) 2%LQT7 (Anderson syndrome) 17q23.1-q24.2 KCNJ2 Potassium (IK1) RareLQT8 (Timothy syndrome) 12q13.3 CACNA1C CalciumRareLQT9 3p25.3 CAV3 Sodium (INa) 0.66%LQT10 11q23.3 SCN4B Sodium (INa) Single familyLQT11 7q21-q22 AKAP9 Potassium (IKs) Single familyLQT12 SNTA1Sodium (INa) Single familyRisk prediction is complex. Although events in LQT1 are more common than in LQT2 and LQT3, events which do occur in these latter two conditions carry a higher risk of death. For patients with LQT1 and LQT2 syndrome the genetic locus and the QTc are independent predictors of risk. For patients with LQT3 the QTc is not an independent predictor, but male patients were noted to be at higher risk, even when their QTc was < 500msPEVuZE5vdGU+PENpdGU+PEF1dGhvcj5Qcmlvcmk8L0F1dGhvcj48WWVhcj4yMDAzPC9ZZWFyPjxS

ZWNOdW0+MjY1MjwvUmVjTnVtPjxyZWNvcmQ+PHJlYy1udW1iZXI+MjY1MjwvcmVjLW51bWJlcj48

Zm9yZWlnbi1rZXlzPjxrZXkgYXBwPSJFTiIgZGItaWQ9ImZyMHR6cHAydjl4dHBvZXdhNTJwMGV2

cXN6MmR2dnN0OXNkMCI+MjY1Mjwva2V5PjwvZm9yZWlnbi1rZXlzPjxyZWYtdHlwZSBuYW1lPSJK

b3VybmFsIEFydGljbGUiPjE3PC9yZWYtdHlwZT48Y29udHJpYnV0b3JzPjxhdXRob3JzPjxhdXRo

b3I+UHJpb3JpLCBTLiBHLjwvYXV0aG9yPjxhdXRob3I+U2Nod2FydHosIFAuIEouPC9hdXRob3I+

PGF1dGhvcj5OYXBvbGl0YW5vLCBDLjwvYXV0aG9yPjxhdXRob3I+QmxvaXNlLCBSLjwvYXV0aG9y

PjxhdXRob3I+Um9uY2hldHRpLCBFLjwvYXV0aG9yPjxhdXRob3I+R3JpbGxvLCBNLjwvYXV0aG9y

PjxhdXRob3I+VmljZW50aW5pLCBBLjwvYXV0aG9yPjxhdXRob3I+U3BhenpvbGluaSwgQy48L2F1

dGhvcj48YXV0aG9yPk5hc3RvbGksIEouPC9hdXRob3I+PGF1dGhvcj5Cb3R0ZWxsaSwgRy48L2F1

dGhvcj48YXV0aG9yPkZvbGxpLCBSLjwvYXV0aG9yPjxhdXRob3I+Q2FwcGVsbGV0dGksIEQuPC9h

dXRob3I+PC9hdXRob3JzPjwvY29udHJpYnV0b3JzPjxhdXRoLWFkZHJlc3M+RGVwYXJ0bWVudCBv

ZiBNb2xlY3VsYXIgQ2FyZGlvbG9neSwgSXN0aXR1dG8gZGkgUmljb3Zlcm8gZSBDdXJhIGEgQ2Fy

YXR0ZXJlIFNjaWVudGlmaWNvIEZvbmRhemlvbmUgUy4gTWF1Z2VyaSwgVW5pdmVyc2l0eSBvZiBQ

YXZpYSwgUGF2aWEsIEl0YWx5LiBzcHJpb3JpQGZzbS5pdC48L2F1dGgtYWRkcmVzcz48dGl0bGVz

Pjx0aXRsZT5SaXNrIHN0cmF0aWZpY2F0aW9uIGluIHRoZSBsb25nLVFUIHN5bmRyb21lPC90aXRs

ZT48c2Vjb25kYXJ5LXRpdGxlPk4gRW5nbCBKIE1lZDwvc2Vjb25kYXJ5LXRpdGxlPjwvdGl0bGVz

PjxwZXJpb2RpY2FsPjxmdWxsLXRpdGxlPk4gRW5nbCBKIE1lZDwvZnVsbC10aXRsZT48L3Blcmlv

ZGljYWw+PHBhZ2VzPjE4NjYtNzQ8L3BhZ2VzPjx2b2x1bWU+MzQ4PC92b2x1bWU+PG51bWJlcj4x

OTwvbnVtYmVyPjxlZGl0aW9uPjIwMDMvMDUvMDk8L2VkaXRpb24+PGtleXdvcmRzPjxrZXl3b3Jk

PkFkdWx0PC9rZXl3b3JkPjxrZXl3b3JkPkFnZSBvZiBPbnNldDwva2V5d29yZD48a2V5d29yZD5E

aXNlYXNlLUZyZWUgU3Vydml2YWw8L2tleXdvcmQ+PGtleXdvcmQ+RWxlY3Ryb2NhcmRpb2dyYXBo

eTwva2V5d29yZD48a2V5d29yZD5GZW1hbGU8L2tleXdvcmQ+PGtleXdvcmQ+R2Vub3R5cGU8L2tl

eXdvcmQ+PGtleXdvcmQ+SGVhcnQgQXJyZXN0L2dlbmV0aWNzPC9rZXl3b3JkPjxrZXl3b3JkPkh1

bWFuczwva2V5d29yZD48a2V5d29yZD5Mb25nIFFUIFN5bmRyb21lLypnZW5ldGljczwva2V5d29y

ZD48a2V5d29yZD5NYWxlPC9rZXl3b3JkPjxrZXl3b3JkPk11bHRpdmFyaWF0ZSBBbmFseXNpczwv

a2V5d29yZD48a2V5d29yZD5NdXRhdGlvbjwva2V5d29yZD48a2V5d29yZD5QaGVub3R5cGU8L2tl

eXdvcmQ+PGtleXdvcmQ+UG90YXNzaXVtIENoYW5uZWxzL2dlbmV0aWNzPC9rZXl3b3JkPjxrZXl3

b3JkPlJpc2sgQXNzZXNzbWVudC8qbWV0aG9kczwva2V5d29yZD48a2V5d29yZD5Tb2RpdW0gQ2hh

bm5lbHMvZ2VuZXRpY3M8L2tleXdvcmQ+PC9rZXl3b3Jkcz48ZGF0ZXM+PHllYXI+MjAwMzwveWVh

cj48cHViLWRhdGVzPjxkYXRlPk1heSA4PC9kYXRlPjwvcHViLWRhdGVzPjwvZGF0ZXM+PGlzYm4+

MTUzMy00NDA2IChFbGVjdHJvbmljKTwvaXNibj48YWNjZXNzaW9uLW51bT4xMjczNjI3OTwvYWNj

ZXNzaW9uLW51bT48dXJscz48cmVsYXRlZC11cmxzPjx1cmw+aHR0cDovL3d3dy5uY2JpLm5sbS5u

aWguZ292L2VudHJlei9xdWVyeS5mY2dpP2NtZD1SZXRyaWV2ZSZhbXA7ZGI9UHViTWVkJmFtcDtk

b3B0PUNpdGF0aW9uJmFtcDtsaXN0X3VpZHM9MTI3MzYyNzk8L3VybD48L3JlbGF0ZWQtdXJscz48

L3VybHM+PGVsZWN0cm9uaWMtcmVzb3VyY2UtbnVtPjEwLjEwNTYvTkVKTW9hMDIyMTQ3JiN4RDsz

NDgvMTkvMTg2NiBbcGlpXTwvZWxlY3Ryb25pYy1yZXNvdXJjZS1udW0+PGxhbmd1YWdlPmVuZzwv

bGFuZ3VhZ2U+PC9yZWNvcmQ+PC9DaXRlPjwvRW5kTm90ZT4AAD==

ADDIN EN.CITE PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5Qcmlvcmk8L0F1dGhvcj48WWVhcj4yMDAzPC9ZZWFyPjxS

ZWNOdW0+MjY1MjwvUmVjTnVtPjxyZWNvcmQ+PHJlYy1udW1iZXI+MjY1MjwvcmVjLW51bWJlcj48

Zm9yZWlnbi1rZXlzPjxrZXkgYXBwPSJFTiIgZGItaWQ9ImZyMHR6cHAydjl4dHBvZXdhNTJwMGV2

cXN6MmR2dnN0OXNkMCI+MjY1Mjwva2V5PjwvZm9yZWlnbi1rZXlzPjxyZWYtdHlwZSBuYW1lPSJK

b3VybmFsIEFydGljbGUiPjE3PC9yZWYtdHlwZT48Y29udHJpYnV0b3JzPjxhdXRob3JzPjxhdXRo

b3I+UHJpb3JpLCBTLiBHLjwvYXV0aG9yPjxhdXRob3I+U2Nod2FydHosIFAuIEouPC9hdXRob3I+

PGF1dGhvcj5OYXBvbGl0YW5vLCBDLjwvYXV0aG9yPjxhdXRob3I+QmxvaXNlLCBSLjwvYXV0aG9y

PjxhdXRob3I+Um9uY2hldHRpLCBFLjwvYXV0aG9yPjxhdXRob3I+R3JpbGxvLCBNLjwvYXV0aG9y

PjxhdXRob3I+VmljZW50aW5pLCBBLjwvYXV0aG9yPjxhdXRob3I+U3BhenpvbGluaSwgQy48L2F1

dGhvcj48YXV0aG9yPk5hc3RvbGksIEouPC9hdXRob3I+PGF1dGhvcj5Cb3R0ZWxsaSwgRy48L2F1

dGhvcj48YXV0aG9yPkZvbGxpLCBSLjwvYXV0aG9yPjxhdXRob3I+Q2FwcGVsbGV0dGksIEQuPC9h

dXRob3I+PC9hdXRob3JzPjwvY29udHJpYnV0b3JzPjxhdXRoLWFkZHJlc3M+RGVwYXJ0bWVudCBv

ZiBNb2xlY3VsYXIgQ2FyZGlvbG9neSwgSXN0aXR1dG8gZGkgUmljb3Zlcm8gZSBDdXJhIGEgQ2Fy

YXR0ZXJlIFNjaWVudGlmaWNvIEZvbmRhemlvbmUgUy4gTWF1Z2VyaSwgVW5pdmVyc2l0eSBvZiBQ

YXZpYSwgUGF2aWEsIEl0YWx5LiBzcHJpb3JpQGZzbS5pdC48L2F1dGgtYWRkcmVzcz48dGl0bGVz

Pjx0aXRsZT5SaXNrIHN0cmF0aWZpY2F0aW9uIGluIHRoZSBsb25nLVFUIHN5bmRyb21lPC90aXRs

ZT48c2Vjb25kYXJ5LXRpdGxlPk4gRW5nbCBKIE1lZDwvc2Vjb25kYXJ5LXRpdGxlPjwvdGl0bGVz

PjxwZXJpb2RpY2FsPjxmdWxsLXRpdGxlPk4gRW5nbCBKIE1lZDwvZnVsbC10aXRsZT48L3Blcmlv

ZGljYWw+PHBhZ2VzPjE4NjYtNzQ8L3BhZ2VzPjx2b2x1bWU+MzQ4PC92b2x1bWU+PG51bWJlcj4x

OTwvbnVtYmVyPjxlZGl0aW9uPjIwMDMvMDUvMDk8L2VkaXRpb24+PGtleXdvcmRzPjxrZXl3b3Jk

PkFkdWx0PC9rZXl3b3JkPjxrZXl3b3JkPkFnZSBvZiBPbnNldDwva2V5d29yZD48a2V5d29yZD5E

aXNlYXNlLUZyZWUgU3Vydml2YWw8L2tleXdvcmQ+PGtleXdvcmQ+RWxlY3Ryb2NhcmRpb2dyYXBo

eTwva2V5d29yZD48a2V5d29yZD5GZW1hbGU8L2tleXdvcmQ+PGtleXdvcmQ+R2Vub3R5cGU8L2tl

eXdvcmQ+PGtleXdvcmQ+SGVhcnQgQXJyZXN0L2dlbmV0aWNzPC9rZXl3b3JkPjxrZXl3b3JkPkh1

bWFuczwva2V5d29yZD48a2V5d29yZD5Mb25nIFFUIFN5bmRyb21lLypnZW5ldGljczwva2V5d29y

ZD48a2V5d29yZD5NYWxlPC9rZXl3b3JkPjxrZXl3b3JkPk11bHRpdmFyaWF0ZSBBbmFseXNpczwv

a2V5d29yZD48a2V5d29yZD5NdXRhdGlvbjwva2V5d29yZD48a2V5d29yZD5QaGVub3R5cGU8L2tl

eXdvcmQ+PGtleXdvcmQ+UG90YXNzaXVtIENoYW5uZWxzL2dlbmV0aWNzPC9rZXl3b3JkPjxrZXl3

b3JkPlJpc2sgQXNzZXNzbWVudC8qbWV0aG9kczwva2V5d29yZD48a2V5d29yZD5Tb2RpdW0gQ2hh

bm5lbHMvZ2VuZXRpY3M8L2tleXdvcmQ+PC9rZXl3b3Jkcz48ZGF0ZXM+PHllYXI+MjAwMzwveWVh

cj48cHViLWRhdGVzPjxkYXRlPk1heSA4PC9kYXRlPjwvcHViLWRhdGVzPjwvZGF0ZXM+PGlzYm4+

MTUzMy00NDA2IChFbGVjdHJvbmljKTwvaXNibj48YWNjZXNzaW9uLW51bT4xMjczNjI3OTwvYWNj

ZXNzaW9uLW51bT48dXJscz48cmVsYXRlZC11cmxzPjx1cmw+aHR0cDovL3d3dy5uY2JpLm5sbS5u

aWguZ292L2VudHJlei9xdWVyeS5mY2dpP2NtZD1SZXRyaWV2ZSZhbXA7ZGI9UHViTWVkJmFtcDtk

b3B0PUNpdGF0aW9uJmFtcDtsaXN0X3VpZHM9MTI3MzYyNzk8L3VybD48L3JlbGF0ZWQtdXJscz48

L3VybHM+PGVsZWN0cm9uaWMtcmVzb3VyY2UtbnVtPjEwLjEwNTYvTkVKTW9hMDIyMTQ3JiN4RDsz

NDgvMTkvMTg2NiBbcGlpXTwvZWxlY3Ryb25pYy1yZXNvdXJjZS1udW0+PGxhbmd1YWdlPmVuZzwv

bGFuZ3VhZ2U+PC9yZWNvcmQ+PC9DaXRlPjwvRW5kTm90ZT5cAD==

ADDIN EN.CITE.DATA 26. Patients with more than one mutation tend to have a longer QTc and a significantly higher risk of death.The current UK stance recommends genetic testing for confirmed clinical cases of LQTS only ADDIN EN.CITE <EndNote><Cite><Year>2008</Year><RecNum>6841</RecNum><record><rec-number>6841</rec-number><foreign-keys><key app="EN" db-id="fr0tzpp2v9xtpoewa52p0evqsz2dvvst9sd0">6841</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors></contributors><auth-address>Manchester Heart Centre, Manchester Royal Infirmary, Oxford Road, Manchester M13 9WL, UK. clifford.garratt@cmmc.nhs.uk</auth-address><titles><title>Clinical indications for genetic testing in familial sudden cardiac death syndromes: an HRUK position statement</title><secondary-title>Heart</secondary-title></titles><periodical><full-title>Heart</full-title></periodical><pages>502-7</pages><volume>94</volume><number>4</number><edition>2007/08/01</edition><keywords><keyword>Adult</keyword><keyword>Age Factors</keyword><keyword>Cost-Benefit Analysis</keyword><keyword>Death, Sudden, Cardiac/*etiology/prevention &amp; control</keyword><keyword>Evidence-Based Medicine</keyword><keyword>Genetic Counseling/methods</keyword><keyword>Genetic Diseases, Inborn/diagnosis</keyword><keyword>*Genetic Predisposition to Disease</keyword><keyword>Genetic Testing/economics/*methods</keyword><keyword>Heart Diseases/diagnosis/genetics</keyword><keyword>Humans</keyword><keyword>Patient Selection</keyword><keyword>Sensitivity and Specificity</keyword></keywords><dates><year>2008</year><pub-dates><date>Apr</date></pub-dates></dates><isbn>1468-201X (Electronic)&#xD;1355-6037 (Linking)</isbn><accession-num>17664186</accession-num><urls><related-urls><url> [pii]&#xD;10.1136/hrt.2007.127761</electronic-resource-num><language>eng</language></record></Cite></EndNote>27. A confirmed clinical case would correspond with a Schwartz score of ≥ 4. Genetic testing of 1st degree relatives of an index case in whom the mutation has been identified is also recommended. Genetic testing for borderline cases to confirm or refute the diagnosis is not recommended routinely. The current approach is to target the most commonly involved genes, often in a sequential manner, although these guidelines will almost certainly change in the future as new sequencing techniques become available and costs reduce.ManagementThe fact that this is a disease which has a genetic basis should be discussed with the patient and the potential need to screen relatives for the same condition should be broached. A more complete discussion of the implications is probably not practical in the cardiology out-patient setting and referral to a clinical genetics service is recommended. Genetic testing for the individual and relatives may be appropriate and a decision should be made by the cardiologist, geneticist and affected (or potentially affected) individual. A combination of phenotype and genotype can inform management.It is reasonable to give lifestyle advice. In particular for LQT1 strenuous exercise should be avoided, particularly swimming, although avoidance of strenuous exercise is recommended for all forms of LQTSPEVuZE5vdGU+PENpdGU+PEF1dGhvcj5aaXBlczwvQXV0aG9yPjxZZWFyPjIwMDY8L1llYXI+PFJl

Y051bT41NDI3PC9SZWNOdW0+PHJlY29yZD48cmVjLW51bWJlcj41NDI3PC9yZWMtbnVtYmVyPjxm

b3JlaWduLWtleXM+PGtleSBhcHA9IkVOIiBkYi1pZD0iZnIwdHpwcDJ2OXh0cG9ld2E1MnAwZXZx

c3oyZHZ2c3Q5c2QwIj41NDI3PC9rZXk+PC9mb3JlaWduLWtleXM+PHJlZi10eXBlIG5hbWU9Ikpv

dXJuYWwgQXJ0aWNsZSI+MTc8L3JlZi10eXBlPjxjb250cmlidXRvcnM+PGF1dGhvcnM+PGF1dGhv

cj5aaXBlcywgRC4gUC48L2F1dGhvcj48YXV0aG9yPkNhbW0sIEEuIEouPC9hdXRob3I+PGF1dGhv

cj5Cb3JnZ3JlZmUsIE0uPC9hdXRob3I+PGF1dGhvcj5CdXh0b24sIEEuIEUuPC9hdXRob3I+PGF1

dGhvcj5DaGFpdG1hbiwgQi48L2F1dGhvcj48YXV0aG9yPkZyb21lciwgTS48L2F1dGhvcj48YXV0

aG9yPkdyZWdvcmF0b3MsIEcuPC9hdXRob3I+PGF1dGhvcj5LbGVpbiwgRy48L2F1dGhvcj48YXV0

aG9yPk1vc3MsIEEuIEouPC9hdXRob3I+PGF1dGhvcj5NeWVyYnVyZywgUi4gSi48L2F1dGhvcj48

YXV0aG9yPlByaW9yaSwgUy4gRy48L2F1dGhvcj48YXV0aG9yPlF1aW5vbmVzLCBNLiBBLjwvYXV0

aG9yPjxhdXRob3I+Um9kZW4sIEQuIE0uPC9hdXRob3I+PGF1dGhvcj5TaWxrYSwgTS4gSi48L2F1

dGhvcj48YXV0aG9yPlRyYWN5LCBDLjwvYXV0aG9yPjxhdXRob3I+U21pdGgsIFMuIEMuLCBKci48

L2F1dGhvcj48YXV0aG9yPkphY29icywgQS4gSy48L2F1dGhvcj48YXV0aG9yPkFkYW1zLCBDLiBE

LjwvYXV0aG9yPjxhdXRob3I+QW50bWFuLCBFLiBNLjwvYXV0aG9yPjxhdXRob3I+QW5kZXJzb24s

IEouIEwuPC9hdXRob3I+PGF1dGhvcj5IdW50LCBTLiBBLjwvYXV0aG9yPjxhdXRob3I+SGFscGVy

aW4sIEouIEwuPC9hdXRob3I+PGF1dGhvcj5OaXNoaW11cmEsIFIuPC9hdXRob3I+PGF1dGhvcj5P

cm5hdG8sIEouIFAuPC9hdXRob3I+PGF1dGhvcj5QYWdlLCBSLiBMLjwvYXV0aG9yPjxhdXRob3I+

UmllZ2VsLCBCLjwvYXV0aG9yPjxhdXRob3I+QmxhbmMsIEouIEouPC9hdXRob3I+PGF1dGhvcj5C

dWRhaiwgQS48L2F1dGhvcj48YXV0aG9yPkRlYW4sIFYuPC9hdXRob3I+PGF1dGhvcj5EZWNrZXJz

LCBKLiBXLjwvYXV0aG9yPjxhdXRob3I+RGVzcHJlcywgQy48L2F1dGhvcj48YXV0aG9yPkRpY2tz

dGVpbiwgSy48L2F1dGhvcj48YXV0aG9yPkxla2FraXMsIEouPC9hdXRob3I+PGF1dGhvcj5NY0dy

ZWdvciwgSy48L2F1dGhvcj48YXV0aG9yPk1ldHJhLCBNLjwvYXV0aG9yPjxhdXRob3I+TW9yYWlz

LCBKLjwvYXV0aG9yPjxhdXRob3I+T3N0ZXJzcGV5LCBBLjwvYXV0aG9yPjxhdXRob3I+VGFtYXJn

bywgSi4gTC48L2F1dGhvcj48YXV0aG9yPlphbW9yYW5vLCBKLiBMLjwvYXV0aG9yPjwvYXV0aG9y

cz48L2NvbnRyaWJ1dG9ycz48dGl0bGVzPjx0aXRsZT5BQ0MvQUhBL0VTQyAyMDA2IEd1aWRlbGlu

ZXMgZm9yIE1hbmFnZW1lbnQgb2YgUGF0aWVudHMgV2l0aCBWZW50cmljdWxhciBBcnJoeXRobWlh

cyBhbmQgdGhlIFByZXZlbnRpb24gb2YgU3VkZGVuIENhcmRpYWMgRGVhdGg6IGEgcmVwb3J0IG9m

IHRoZSBBbWVyaWNhbiBDb2xsZWdlIG9mIENhcmRpb2xvZ3kvQW1lcmljYW4gSGVhcnQgQXNzb2Np

YXRpb24gVGFzayBGb3JjZSBhbmQgdGhlIEV1cm9wZWFuIFNvY2lldHkgb2YgQ2FyZGlvbG9neSBD

b21taXR0ZWUgZm9yIFByYWN0aWNlIEd1aWRlbGluZXMgKHdyaXRpbmcgY29tbWl0dGVlIHRvIGRl

dmVsb3AgR3VpZGVsaW5lcyBmb3IgTWFuYWdlbWVudCBvZiBQYXRpZW50cyBXaXRoIFZlbnRyaWN1

bGFyIEFycmh5dGhtaWFzIGFuZCB0aGUgUHJldmVudGlvbiBvZiBTdWRkZW4gQ2FyZGlhYyBEZWF0

aCk6IGRldmVsb3BlZCBpbiBjb2xsYWJvcmF0aW9uIHdpdGggdGhlIEV1cm9wZWFuIEhlYXJ0IFJo

eXRobSBBc3NvY2lhdGlvbiBhbmQgdGhlIEhlYXJ0IFJoeXRobSBTb2NpZXR5PC90aXRsZT48c2Vj

b25kYXJ5LXRpdGxlPkNpcmN1bGF0aW9uPC9zZWNvbmRhcnktdGl0bGU+PC90aXRsZXM+PHBlcmlv

ZGljYWw+PGZ1bGwtdGl0bGU+Q2lyY3VsYXRpb248L2Z1bGwtdGl0bGU+PC9wZXJpb2RpY2FsPjxw

YWdlcz5lMzg1LTQ4NDwvcGFnZXM+PHZvbHVtZT4xMTQ8L3ZvbHVtZT48bnVtYmVyPjEwPC9udW1i

ZXI+PGtleXdvcmRzPjxrZXl3b3JkPkFtZXJpY2FuIEhlYXJ0IEFzc29jaWF0aW9uPC9rZXl3b3Jk

PjxrZXl3b3JkPkFycmh5dGhtaWEvKnRoZXJhcHk8L2tleXdvcmQ+PGtleXdvcmQ+RGVhdGgsIFN1

ZGRlbiwgQ2FyZGlhYy8qcHJldmVudGlvbiAmYW1wOyBjb250cm9sPC9rZXl3b3JkPjxrZXl3b3Jk

PkV1cm9wZTwva2V5d29yZD48a2V5d29yZD5IdW1hbnM8L2tleXdvcmQ+PGtleXdvcmQ+UXVhbGl0

eSBBc3N1cmFuY2UsIEhlYWx0aCBDYXJlPC9rZXl3b3JkPjxrZXl3b3JkPlNvY2lldGllcywgTWVk

aWNhbDwva2V5d29yZD48a2V5d29yZD5WZW50cmljdWxhciBEeXNmdW5jdGlvbi8qdGhlcmFweTwv

a2V5d29yZD48L2tleXdvcmRzPjxkYXRlcz48eWVhcj4yMDA2PC95ZWFyPjwvZGF0ZXM+PGFjY2Vz

c2lvbi1udW0+MTY5MzU5OTU8L2FjY2Vzc2lvbi1udW0+PHVybHM+PHJlbGF0ZWQtdXJscz48dXJs

Pmh0dHA6Ly93d3cubmNiaS5ubG0ubmloLmdvdi9lbnRyZXovcXVlcnkuZmNnaT9jbWQ9UmV0cmll

dmUmYW1wO2RiPVB1Yk1lZCZhbXA7ZG9wdD1DaXRhdGlvbiZhbXA7bGlzdF91aWRzPTE2OTM1OTk1

PC91cmw+PC9yZWxhdGVkLXVybHM+PC91cmxzPjwvcmVjb3JkPjwvQ2l0ZT48L0VuZE5vdGU+AAA=

ADDIN EN.CITE PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5aaXBlczwvQXV0aG9yPjxZZWFyPjIwMDY8L1llYXI+PFJl

Y051bT41NDI3PC9SZWNOdW0+PHJlY29yZD48cmVjLW51bWJlcj41NDI3PC9yZWMtbnVtYmVyPjxm

b3JlaWduLWtleXM+PGtleSBhcHA9IkVOIiBkYi1pZD0iZnIwdHpwcDJ2OXh0cG9ld2E1MnAwZXZx

c3oyZHZ2c3Q5c2QwIj41NDI3PC9rZXk+PC9mb3JlaWduLWtleXM+PHJlZi10eXBlIG5hbWU9Ikpv

dXJuYWwgQXJ0aWNsZSI+MTc8L3JlZi10eXBlPjxjb250cmlidXRvcnM+PGF1dGhvcnM+PGF1dGhv

cj5aaXBlcywgRC4gUC48L2F1dGhvcj48YXV0aG9yPkNhbW0sIEEuIEouPC9hdXRob3I+PGF1dGhv

cj5Cb3JnZ3JlZmUsIE0uPC9hdXRob3I+PGF1dGhvcj5CdXh0b24sIEEuIEUuPC9hdXRob3I+PGF1

dGhvcj5DaGFpdG1hbiwgQi48L2F1dGhvcj48YXV0aG9yPkZyb21lciwgTS48L2F1dGhvcj48YXV0

aG9yPkdyZWdvcmF0b3MsIEcuPC9hdXRob3I+PGF1dGhvcj5LbGVpbiwgRy48L2F1dGhvcj48YXV0

aG9yPk1vc3MsIEEuIEouPC9hdXRob3I+PGF1dGhvcj5NeWVyYnVyZywgUi4gSi48L2F1dGhvcj48

YXV0aG9yPlByaW9yaSwgUy4gRy48L2F1dGhvcj48YXV0aG9yPlF1aW5vbmVzLCBNLiBBLjwvYXV0

aG9yPjxhdXRob3I+Um9kZW4sIEQuIE0uPC9hdXRob3I+PGF1dGhvcj5TaWxrYSwgTS4gSi48L2F1

dGhvcj48YXV0aG9yPlRyYWN5LCBDLjwvYXV0aG9yPjxhdXRob3I+U21pdGgsIFMuIEMuLCBKci48

L2F1dGhvcj48YXV0aG9yPkphY29icywgQS4gSy48L2F1dGhvcj48YXV0aG9yPkFkYW1zLCBDLiBE

LjwvYXV0aG9yPjxhdXRob3I+QW50bWFuLCBFLiBNLjwvYXV0aG9yPjxhdXRob3I+QW5kZXJzb24s

IEouIEwuPC9hdXRob3I+PGF1dGhvcj5IdW50LCBTLiBBLjwvYXV0aG9yPjxhdXRob3I+SGFscGVy

aW4sIEouIEwuPC9hdXRob3I+PGF1dGhvcj5OaXNoaW11cmEsIFIuPC9hdXRob3I+PGF1dGhvcj5P

cm5hdG8sIEouIFAuPC9hdXRob3I+PGF1dGhvcj5QYWdlLCBSLiBMLjwvYXV0aG9yPjxhdXRob3I+

UmllZ2VsLCBCLjwvYXV0aG9yPjxhdXRob3I+QmxhbmMsIEouIEouPC9hdXRob3I+PGF1dGhvcj5C

dWRhaiwgQS48L2F1dGhvcj48YXV0aG9yPkRlYW4sIFYuPC9hdXRob3I+PGF1dGhvcj5EZWNrZXJz

LCBKLiBXLjwvYXV0aG9yPjxhdXRob3I+RGVzcHJlcywgQy48L2F1dGhvcj48YXV0aG9yPkRpY2tz

dGVpbiwgSy48L2F1dGhvcj48YXV0aG9yPkxla2FraXMsIEouPC9hdXRob3I+PGF1dGhvcj5NY0dy

ZWdvciwgSy48L2F1dGhvcj48YXV0aG9yPk1ldHJhLCBNLjwvYXV0aG9yPjxhdXRob3I+TW9yYWlz

LCBKLjwvYXV0aG9yPjxhdXRob3I+T3N0ZXJzcGV5LCBBLjwvYXV0aG9yPjxhdXRob3I+VGFtYXJn

bywgSi4gTC48L2F1dGhvcj48YXV0aG9yPlphbW9yYW5vLCBKLiBMLjwvYXV0aG9yPjwvYXV0aG9y

cz48L2NvbnRyaWJ1dG9ycz48dGl0bGVzPjx0aXRsZT5BQ0MvQUhBL0VTQyAyMDA2IEd1aWRlbGlu

ZXMgZm9yIE1hbmFnZW1lbnQgb2YgUGF0aWVudHMgV2l0aCBWZW50cmljdWxhciBBcnJoeXRobWlh

cyBhbmQgdGhlIFByZXZlbnRpb24gb2YgU3VkZGVuIENhcmRpYWMgRGVhdGg6IGEgcmVwb3J0IG9m

IHRoZSBBbWVyaWNhbiBDb2xsZWdlIG9mIENhcmRpb2xvZ3kvQW1lcmljYW4gSGVhcnQgQXNzb2Np

YXRpb24gVGFzayBGb3JjZSBhbmQgdGhlIEV1cm9wZWFuIFNvY2lldHkgb2YgQ2FyZGlvbG9neSBD

b21taXR0ZWUgZm9yIFByYWN0aWNlIEd1aWRlbGluZXMgKHdyaXRpbmcgY29tbWl0dGVlIHRvIGRl

dmVsb3AgR3VpZGVsaW5lcyBmb3IgTWFuYWdlbWVudCBvZiBQYXRpZW50cyBXaXRoIFZlbnRyaWN1

bGFyIEFycmh5dGhtaWFzIGFuZCB0aGUgUHJldmVudGlvbiBvZiBTdWRkZW4gQ2FyZGlhYyBEZWF0

aCk6IGRldmVsb3BlZCBpbiBjb2xsYWJvcmF0aW9uIHdpdGggdGhlIEV1cm9wZWFuIEhlYXJ0IFJo

eXRobSBBc3NvY2lhdGlvbiBhbmQgdGhlIEhlYXJ0IFJoeXRobSBTb2NpZXR5PC90aXRsZT48c2Vj

b25kYXJ5LXRpdGxlPkNpcmN1bGF0aW9uPC9zZWNvbmRhcnktdGl0bGU+PC90aXRsZXM+PHBlcmlv

ZGljYWw+PGZ1bGwtdGl0bGU+Q2lyY3VsYXRpb248L2Z1bGwtdGl0bGU+PC9wZXJpb2RpY2FsPjxw

YWdlcz5lMzg1LTQ4NDwvcGFnZXM+PHZvbHVtZT4xMTQ8L3ZvbHVtZT48bnVtYmVyPjEwPC9udW1i

ZXI+PGtleXdvcmRzPjxrZXl3b3JkPkFtZXJpY2FuIEhlYXJ0IEFzc29jaWF0aW9uPC9rZXl3b3Jk

PjxrZXl3b3JkPkFycmh5dGhtaWEvKnRoZXJhcHk8L2tleXdvcmQ+PGtleXdvcmQ+RGVhdGgsIFN1

ZGRlbiwgQ2FyZGlhYy8qcHJldmVudGlvbiAmYW1wOyBjb250cm9sPC9rZXl3b3JkPjxrZXl3b3Jk

PkV1cm9wZTwva2V5d29yZD48a2V5d29yZD5IdW1hbnM8L2tleXdvcmQ+PGtleXdvcmQ+UXVhbGl0

eSBBc3N1cmFuY2UsIEhlYWx0aCBDYXJlPC9rZXl3b3JkPjxrZXl3b3JkPlNvY2lldGllcywgTWVk

aWNhbDwva2V5d29yZD48a2V5d29yZD5WZW50cmljdWxhciBEeXNmdW5jdGlvbi8qdGhlcmFweTwv

a2V5d29yZD48L2tleXdvcmRzPjxkYXRlcz48eWVhcj4yMDA2PC95ZWFyPjwvZGF0ZXM+PGFjY2Vz

c2lvbi1udW0+MTY5MzU5OTU8L2FjY2Vzc2lvbi1udW0+PHVybHM+PHJlbGF0ZWQtdXJscz48dXJs

Pmh0dHA6Ly93d3cubmNiaS5ubG0ubmloLmdvdi9lbnRyZXovcXVlcnkuZmNnaT9jbWQ9UmV0cmll

dmUmYW1wO2RiPVB1Yk1lZCZhbXA7ZG9wdD1DaXRhdGlvbiZhbXA7bGlzdF91aWRzPTE2OTM1OTk1

PC91cmw+PC9yZWxhdGVkLXVybHM+PC91cmxzPjwvcmVjb3JkPjwvQ2l0ZT48L0VuZE5vdGU+AAA=

ADDIN EN.CITE.DATA 25. It may be appropriate to teach behavioural techniques to deal with stressful situations and avoid alarm clocks and phones by the bedside in patients with LQT2. All patients with LQTS should avoide drugs which prolong the QT interval or drugs which may result in electrolyte disturbance.Beta-blockers are the mainstay of therapy in patients with LQTS and have been recommended for many years ADDIN EN.CITE <EndNote><Cite><Author>Schwartz</Author><Year>1975</Year><RecNum>5166</RecNum><record><rec-number>5166</rec-number><foreign-keys><key app="EN" db-id="fr0tzpp2v9xtpoewa52p0evqsz2dvvst9sd0">5166</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Schwartz, P. J.</author><author>Periti, M.</author><author>Malliani, A.</author></authors></contributors><titles><title>The long Q-T syndrome</title><secondary-title>Am Heart J</secondary-title></titles><periodical><full-title>Am Heart J</full-title></periodical><pages>378-390</pages><volume>89</volume><dates><year>1975</year></dates><urls></urls></record></Cite></EndNote>28. They should be given to patients with a genetic diagnosis of LQTS even if their QTc is normal. They are variably effective depending upon the type of LQTSPEVuZE5vdGU+PENpdGU+PEF1dGhvcj5Nb3NzPC9BdXRob3I+PFllYXI+MjAwMDwvWWVhcj48UmVj

TnVtPjM2Mzk8L1JlY051bT48cmVjb3JkPjxyZWMtbnVtYmVyPjM2Mzk8L3JlYy1udW1iZXI+PGZv

cmVpZ24ta2V5cz48a2V5IGFwcD0iRU4iIGRiLWlkPSJmcjB0enBwMnY5eHRwb2V3YTUycDBldnFz

ejJkdnZzdDlzZDAiPjM2Mzk8L2tleT48L2ZvcmVpZ24ta2V5cz48cmVmLXR5cGUgbmFtZT0iSm91

cm5hbCBBcnRpY2xlIj4xNzwvcmVmLXR5cGU+PGNvbnRyaWJ1dG9ycz48YXV0aG9ycz48YXV0aG9y

Pk1vc3MsIEEuIEouPC9hdXRob3I+PGF1dGhvcj5aYXJlYmEsIFcuPC9hdXRob3I+PGF1dGhvcj5I

YWxsLCBXLiBKLjwvYXV0aG9yPjxhdXRob3I+U2Nod2FydHosIFAuIEouPC9hdXRob3I+PGF1dGhv

cj5DcmFtcHRvbiwgUi4gUy48L2F1dGhvcj48YXV0aG9yPkJlbmhvcmluLCBKLjwvYXV0aG9yPjxh

dXRob3I+VmluY2VudCwgRy4gTS48L2F1dGhvcj48YXV0aG9yPkxvY2F0aSwgRS4gSC48L2F1dGhv

cj48YXV0aG9yPlByaW9yaSwgUy4gRy48L2F1dGhvcj48YXV0aG9yPk5hcG9saXRhbm8sIEMuPC9h

dXRob3I+PGF1dGhvcj5NZWRpbmEsIEEuPC9hdXRob3I+PGF1dGhvcj5aaGFuZywgTC48L2F1dGhv

cj48YXV0aG9yPlJvYmluc29uLCBKLiBMLjwvYXV0aG9yPjxhdXRob3I+VGltb3RoeSwgSy48L2F1

dGhvcj48YXV0aG9yPlRvd2JpbiwgSi4gQS48L2F1dGhvcj48YXV0aG9yPkFuZHJld3MsIE0uIEwu

PC9hdXRob3I+PC9hdXRob3JzPjwvY29udHJpYnV0b3JzPjxhdXRoLWFkZHJlc3M+RGVwYXJ0bWVu

dCBvZiBNZWRpY2luZSwgVW5pdmVyc2l0eSBvZiBSb2NoZXN0ZXIgU2Nob29sIG9mIE1lZGljaW5l

IGFuZCBEZW50aXN0cnksIE5ZIDE0NjQyLCBVU0EuIGhlYXJ0YWptQGhlYXJ0LnJvY2hlc3Rlci5l

ZHU8L2F1dGgtYWRkcmVzcz48dGl0bGVzPjx0aXRsZT5FZmZlY3RpdmVuZXNzIGFuZCBsaW1pdGF0

aW9ucyBvZiBiZXRhLWJsb2NrZXIgdGhlcmFweSBpbiBjb25nZW5pdGFsIGxvbmctUVQgc3luZHJv

bWU8L3RpdGxlPjxzZWNvbmRhcnktdGl0bGU+Q2lyY3VsYXRpb248L3NlY29uZGFyeS10aXRsZT48

L3RpdGxlcz48cGVyaW9kaWNhbD48ZnVsbC10aXRsZT5DaXJjdWxhdGlvbjwvZnVsbC10aXRsZT48

L3BlcmlvZGljYWw+PHBhZ2VzPjYxNi0yMzwvcGFnZXM+PHZvbHVtZT4xMDE8L3ZvbHVtZT48bnVt

YmVyPjY8L251bWJlcj48ZWRpdGlvbj4yMDAwLzAyLzE1PC9lZGl0aW9uPjxrZXl3b3Jkcz48a2V5

d29yZD5BZG9sZXNjZW50PC9rZXl3b3JkPjxrZXl3b3JkPkFkcmVuZXJnaWMgYmV0YS1BbnRhZ29u

aXN0cy8qYWRtaW5pc3RyYXRpb24gJmFtcDsgZG9zYWdlL2FkdmVyc2UgZWZmZWN0czwva2V5d29y

ZD48a2V5d29yZD5BZHVsdDwva2V5d29yZD48a2V5d29yZD5BdGVub2xvbC9hZG1pbmlzdHJhdGlv

biAmYW1wOyBkb3NhZ2UvYWR2ZXJzZSBlZmZlY3RzPC9rZXl3b3JkPjxrZXl3b3JkPkNoaWxkPC9r

ZXl3b3JkPjxrZXl3b3JkPkNoaWxkLCBQcmVzY2hvb2w8L2tleXdvcmQ+PGtleXdvcmQ+RmVtYWxl

PC9rZXl3b3JkPjxrZXl3b3JkPkh1bWFuczwva2V5d29yZD48a2V5d29yZD5JbmZhbnQ8L2tleXdv

cmQ+PGtleXdvcmQ+TG9uZyBRVCBTeW5kcm9tZS9jb25nZW5pdGFsLypkcnVnIHRoZXJhcHkvcGh5

c2lvcGF0aG9sb2d5PC9rZXl3b3JkPjxrZXl3b3JkPk1hbGU8L2tleXdvcmQ+PGtleXdvcmQ+TWV0

b3Byb2xvbC9hZG1pbmlzdHJhdGlvbiAmYW1wOyBkb3NhZ2UvYWR2ZXJzZSBlZmZlY3RzPC9rZXl3

b3JkPjxrZXl3b3JkPk5hZG9sb2wvYWRtaW5pc3RyYXRpb24gJmFtcDsgZG9zYWdlL2FkdmVyc2Ug

ZWZmZWN0czwva2V5d29yZD48a2V5d29yZD5Qcm9wcmFub2xvbC9hZG1pbmlzdHJhdGlvbiAmYW1w

OyBkb3NhZ2UvYWR2ZXJzZSBlZmZlY3RzPC9rZXl3b3JkPjxrZXl3b3JkPlN1cnZpdmFsIEFuYWx5

c2lzPC9rZXl3b3JkPjwva2V5d29yZHM+PGRhdGVzPjx5ZWFyPjIwMDA8L3llYXI+PHB1Yi1kYXRl

cz48ZGF0ZT5GZWIgMTU8L2RhdGU+PC9wdWItZGF0ZXM+PC9kYXRlcz48aXNibj4xNTI0LTQ1Mzkg

KEVsZWN0cm9uaWMpPC9pc2JuPjxhY2Nlc3Npb24tbnVtPjEwNjczMjUzPC9hY2Nlc3Npb24tbnVt

Pjx1cmxzPjxyZWxhdGVkLXVybHM+PHVybD5odHRwOi8vd3d3Lm5jYmkubmxtLm5paC5nb3YvZW50

cmV6L3F1ZXJ5LmZjZ2k/Y21kPVJldHJpZXZlJmFtcDtkYj1QdWJNZWQmYW1wO2RvcHQ9Q2l0YXRp

b24mYW1wO2xpc3RfdWlkcz0xMDY3MzI1MzwvdXJsPjwvcmVsYXRlZC11cmxzPjwvdXJscz48bGFu

Z3VhZ2U+ZW5nPC9sYW5ndWFnZT48L3JlY29yZD48L0NpdGU+PENpdGU+PEF1dGhvcj5Qcmlvcmk8

L0F1dGhvcj48WWVhcj4yMDA0PC9ZZWFyPjxSZWNOdW0+MjE0NDwvUmVjTnVtPjxyZWNvcmQ+PHJl

Yy1udW1iZXI+MjE0NDwvcmVjLW51bWJlcj48Zm9yZWlnbi1rZXlzPjxrZXkgYXBwPSJFTiIgZGIt

aWQ9ImZyMHR6cHAydjl4dHBvZXdhNTJwMGV2cXN6MmR2dnN0OXNkMCI+MjE0NDwva2V5PjwvZm9y

ZWlnbi1rZXlzPjxyZWYtdHlwZSBuYW1lPSJKb3VybmFsIEFydGljbGUiPjE3PC9yZWYtdHlwZT48

Y29udHJpYnV0b3JzPjxhdXRob3JzPjxhdXRob3I+UHJpb3JpLCBTLiBHLjwvYXV0aG9yPjxhdXRo

b3I+TmFwb2xpdGFubywgQy48L2F1dGhvcj48YXV0aG9yPlNjaHdhcnR6LCBQLiBKLjwvYXV0aG9y

PjxhdXRob3I+R3JpbGxvLCBNLjwvYXV0aG9yPjxhdXRob3I+QmxvaXNlLCBSLjwvYXV0aG9yPjxh

dXRob3I+Um9uY2hldHRpLCBFLjwvYXV0aG9yPjxhdXRob3I+TW9uY2Fsdm8sIEMuPC9hdXRob3I+

PGF1dGhvcj5UdWxpcGFuaSwgQy48L2F1dGhvcj48YXV0aG9yPlZlaWEsIEEuPC9hdXRob3I+PGF1

dGhvcj5Cb3R0ZWxsaSwgRy48L2F1dGhvcj48YXV0aG9yPk5hc3RvbGksIEouPC9hdXRob3I+PC9h

dXRob3JzPjwvY29udHJpYnV0b3JzPjxhdXRoLWFkZHJlc3M+TW9sZWN1bGFyIENhcmRpb2xvZ3ks

IElSQ0NTIEZvbmRhemlvbmUgTWF1Z2VyaSwgVW5pdmVyc2l0eSBvZiBQYXZpYSwgUGF2aWEsIEl0

YWx5LiBzcHJpb3JpQGZzbS5pdDwvYXV0aC1hZGRyZXNzPjx0aXRsZXM+PHRpdGxlPkFzc29jaWF0

aW9uIG9mIGxvbmcgUVQgc3luZHJvbWUgbG9jaSBhbmQgY2FyZGlhYyBldmVudHMgYW1vbmcgcGF0

aWVudHMgdHJlYXRlZCB3aXRoIGJldGEtYmxvY2tlcnM8L3RpdGxlPjxzZWNvbmRhcnktdGl0bGU+

SkFNQTwvc2Vjb25kYXJ5LXRpdGxlPjwvdGl0bGVzPjxwZXJpb2RpY2FsPjxmdWxsLXRpdGxlPkpB

TUE8L2Z1bGwtdGl0bGU+PC9wZXJpb2RpY2FsPjxwYWdlcz4xMzQxLTQ8L3BhZ2VzPjx2b2x1bWU+

MjkyPC92b2x1bWU+PG51bWJlcj4xMTwvbnVtYmVyPjxlZGl0aW9uPjIwMDQvMDkvMTY8L2VkaXRp

b24+PGtleXdvcmRzPjxrZXl3b3JkPkFkcmVuZXJnaWMgYmV0YS1BbnRhZ29uaXN0cy8qdGhlcmFw

ZXV0aWMgdXNlPC9rZXl3b3JkPjxrZXl3b3JkPkFkdWx0PC9rZXl3b3JkPjxrZXl3b3JkPkRpc2Vh

c2UgUHJvZ3Jlc3Npb248L2tleXdvcmQ+PGtleXdvcmQ+RXRoZXItQS1Hby1HbyBQb3Rhc3NpdW0g

Q2hhbm5lbHM8L2tleXdvcmQ+PGtleXdvcmQ+R2Vub3R5cGU8L2tleXdvcmQ+PGtleXdvcmQ+SHVt

YW5zPC9rZXl3b3JkPjxrZXl3b3JkPktDTlEgUG90YXNzaXVtIENoYW5uZWxzPC9rZXl3b3JkPjxr

ZXl3b3JkPktDTlExIFBvdGFzc2l1bSBDaGFubmVsPC9rZXl3b3JkPjxrZXl3b3JkPkxvbmcgUVQg

U3luZHJvbWUvKmRydWcgdGhlcmFweS8qZ2VuZXRpY3MvcGh5c2lvcGF0aG9sb2d5PC9rZXl3b3Jk

PjxrZXl3b3JkPlBvdGFzc2l1bSBDaGFubmVscy9nZW5ldGljczwva2V5d29yZD48a2V5d29yZD4q

UG90YXNzaXVtIENoYW5uZWxzLCBWb2x0YWdlLUdhdGVkPC9rZXl3b3JkPjxrZXl3b3JkPlNvZGl1

bSBDaGFubmVscy9nZW5ldGljczwva2V5d29yZD48a2V5d29yZD5TdXJ2aXZhbCBBbmFseXNpczwv

a2V5d29yZD48a2V5d29yZD5UcmVhdG1lbnQgT3V0Y29tZTwva2V5d29yZD48L2tleXdvcmRzPjxk

YXRlcz48eWVhcj4yMDA0PC95ZWFyPjxwdWItZGF0ZXM+PGRhdGU+U2VwIDE1PC9kYXRlPjwvcHVi

LWRhdGVzPjwvZGF0ZXM+PGlzYm4+MTUzOC0zNTk4IChFbGVjdHJvbmljKTwvaXNibj48YWNjZXNz

aW9uLW51bT4xNTM2NzU1NjwvYWNjZXNzaW9uLW51bT48dXJscz48cmVsYXRlZC11cmxzPjx1cmw+

aHR0cDovL3d3dy5uY2JpLm5sbS5uaWguZ292L2VudHJlei9xdWVyeS5mY2dpP2NtZD1SZXRyaWV2

ZSZhbXA7ZGI9UHViTWVkJmFtcDtkb3B0PUNpdGF0aW9uJmFtcDtsaXN0X3VpZHM9MTUzNjc1NTY8

L3VybD48L3JlbGF0ZWQtdXJscz48L3VybHM+PGVsZWN0cm9uaWMtcmVzb3VyY2UtbnVtPjEwLjEw

MDEvamFtYS4yOTIuMTEuMTM0MSYjeEQ7MjkyLzExLzEzNDEgW3BpaV08L2VsZWN0cm9uaWMtcmVz

b3VyY2UtbnVtPjxsYW5ndWFnZT5lbmc8L2xhbmd1YWdlPjwvcmVjb3JkPjwvQ2l0ZT48Q2l0ZT48

QXV0aG9yPlNjaHdhcnR6PC9BdXRob3I+PFllYXI+MjAwMTwvWWVhcj48UmVjTnVtPjM0MTE8L1Jl

Y051bT48cmVjb3JkPjxyZWMtbnVtYmVyPjM0MTE8L3JlYy1udW1iZXI+PGZvcmVpZ24ta2V5cz48

a2V5IGFwcD0iRU4iIGRiLWlkPSJmcjB0enBwMnY5eHRwb2V3YTUycDBldnFzejJkdnZzdDlzZDAi

PjM0MTE8L2tleT48L2ZvcmVpZ24ta2V5cz48cmVmLXR5cGUgbmFtZT0iSm91cm5hbCBBcnRpY2xl

Ij4xNzwvcmVmLXR5cGU+PGNvbnRyaWJ1dG9ycz48YXV0aG9ycz48YXV0aG9yPlNjaHdhcnR6LCBQ

LiBKLjwvYXV0aG9yPjxhdXRob3I+UHJpb3JpLCBTLiBHLjwvYXV0aG9yPjxhdXRob3I+U3Bhenpv

bGluaSwgQy48L2F1dGhvcj48YXV0aG9yPk1vc3MsIEEuIEouPC9hdXRob3I+PGF1dGhvcj5WaW5j

ZW50LCBHLiBNLjwvYXV0aG9yPjxhdXRob3I+TmFwb2xpdGFubywgQy48L2F1dGhvcj48YXV0aG9y

PkRlbmpveSwgSS48L2F1dGhvcj48YXV0aG9yPkd1aWNoZW5leSwgUC48L2F1dGhvcj48YXV0aG9y

PkJyZWl0aGFyZHQsIEcuPC9hdXRob3I+PGF1dGhvcj5LZWF0aW5nLCBNLiBULjwvYXV0aG9yPjxh

dXRob3I+VG93YmluLCBKLiBBLjwvYXV0aG9yPjxhdXRob3I+QmVnZ3MsIEEuIEguPC9hdXRob3I+

PGF1dGhvcj5CcmluaywgUC48L2F1dGhvcj48YXV0aG9yPldpbGRlLCBBLiBBLjwvYXV0aG9yPjxh

dXRob3I+VG9pdm9uZW4sIEwuPC9hdXRob3I+PGF1dGhvcj5aYXJlYmEsIFcuPC9hdXRob3I+PGF1

dGhvcj5Sb2JpbnNvbiwgSi4gTC48L2F1dGhvcj48YXV0aG9yPlRpbW90aHksIEsuIFcuPC9hdXRo

b3I+PGF1dGhvcj5Db3JmaWVsZCwgVi48L2F1dGhvcj48YXV0aG9yPldhdHRhbmFzaXJpY2hhaWdv

b24sIEQuPC9hdXRob3I+PGF1dGhvcj5Db3JiZXR0LCBDLjwvYXV0aG9yPjxhdXRob3I+SGF2ZXJr

YW1wLCBXLjwvYXV0aG9yPjxhdXRob3I+U2NodWx6ZS1CYWhyLCBFLjwvYXV0aG9yPjxhdXRob3I+

TGVobWFubiwgTS4gSC48L2F1dGhvcj48YXV0aG9yPlNjaHdhcnR6LCBLLjwvYXV0aG9yPjxhdXRo

b3I+Q291bWVsLCBQLjwvYXV0aG9yPjxhdXRob3I+QmxvaXNlLCBSLjwvYXV0aG9yPjwvYXV0aG9y

cz48L2NvbnRyaWJ1dG9ycz48YXV0aC1hZGRyZXNzPkRlcGFydG1lbnQgb2YgQ2FyZGlvbG9neSwg

UG9saWNsaW5pY28gUy4gTWF0dGVvIElSQ0NTIGFuZCBVbml2ZXJzaXR5IG9mIFBhdmlhLCBQYXZp

YSwgSXRhbHkuIFBKUVRAY29tcHVzZXJ2ZS5jb208L2F1dGgtYWRkcmVzcz48dGl0bGVzPjx0aXRs

ZT5HZW5vdHlwZS1waGVub3R5cGUgY29ycmVsYXRpb24gaW4gdGhlIGxvbmctUVQgc3luZHJvbWU6

IGdlbmUtc3BlY2lmaWMgdHJpZ2dlcnMgZm9yIGxpZmUtdGhyZWF0ZW5pbmcgYXJyaHl0aG1pYXM8

L3RpdGxlPjxzZWNvbmRhcnktdGl0bGU+Q2lyY3VsYXRpb248L3NlY29uZGFyeS10aXRsZT48L3Rp

dGxlcz48cGVyaW9kaWNhbD48ZnVsbC10aXRsZT5DaXJjdWxhdGlvbjwvZnVsbC10aXRsZT48L3Bl

cmlvZGljYWw+PHBhZ2VzPjg5LTk1PC9wYWdlcz48dm9sdW1lPjEwMzwvdm9sdW1lPjxudW1iZXI+

MTwvbnVtYmVyPjxlZGl0aW9uPjIwMDEvMDEvMDQ8L2VkaXRpb24+PGtleXdvcmRzPjxrZXl3b3Jk

PkFkcmVuZXJnaWMgYmV0YS1BbnRhZ29uaXN0cy90aGVyYXBldXRpYyB1c2U8L2tleXdvcmQ+PGtl

eXdvcmQ+QWR1bHQ8L2tleXdvcmQ+PGtleXdvcmQ+QXJyaHl0aG1pYXMsIENhcmRpYWMvZXRpb2xv

Z3kvZ2VuZXRpY3MvcGh5c2lvcGF0aG9sb2d5PC9rZXl3b3JkPjxrZXl3b3JkPkRlYXRoLCBTdWRk

ZW4sIENhcmRpYWMvZXRpb2xvZ3k8L2tleXdvcmQ+PGtleXdvcmQ+RWxlY3Ryb2NhcmRpb2dyYXBo

eTwva2V5d29yZD48a2V5d29yZD5FbW90aW9uczwva2V5d29yZD48a2V5d29yZD5FeGVyY2lzZTwv

a2V5d29yZD48a2V5d29yZD5GZW1hbGU8L2tleXdvcmQ+PGtleXdvcmQ+R2Vub3R5cGU8L2tleXdv

cmQ+PGtleXdvcmQ+SHVtYW5zPC9rZXl3b3JkPjxrZXl3b3JkPklvbiBDaGFubmVscy9nZW5ldGlj

czwva2V5d29yZD48a2V5d29yZD5Mb25nIFFUIFN5bmRyb21lL2NsYXNzaWZpY2F0aW9uL2RpYWdu

b3Npcy9kcnVnPC9rZXl3b3JkPjxrZXl3b3JkPnRoZXJhcHkvKmdlbmV0aWNzL3BoeXNpb3BhdGhv

bG9neTwva2V5d29yZD48a2V5d29yZD5NYWxlPC9rZXl3b3JkPjxrZXl3b3JkPlBoZW5vdHlwZTwv

a2V5d29yZD48a2V5d29yZD5TZXggRmFjdG9yczwva2V5d29yZD48a2V5d29yZD5TbGVlcDwva2V5

d29yZD48a2V5d29yZD5TdXJ2aXZhbCBSYXRlPC9rZXl3b3JkPjxrZXl3b3JkPlN5bmNvcGUvZXRp

b2xvZ3k8L2tleXdvcmQ+PC9rZXl3b3Jkcz48ZGF0ZXM+PHllYXI+MjAwMTwveWVhcj48cHViLWRh

dGVzPjxkYXRlPkphbiAyPC9kYXRlPjwvcHViLWRhdGVzPjwvZGF0ZXM+PGlzYm4+MTUyNC00NTM5

IChFbGVjdHJvbmljKTwvaXNibj48YWNjZXNzaW9uLW51bT4xMTEzNjY5MTwvYWNjZXNzaW9uLW51

bT48dXJscz48cmVsYXRlZC11cmxzPjx1cmw+aHR0cDovL3d3dy5uY2JpLm5sbS5uaWguZ292L2Vu

dHJlei9xdWVyeS5mY2dpP2NtZD1SZXRyaWV2ZSZhbXA7ZGI9UHViTWVkJmFtcDtkb3B0PUNpdGF0

aW9uJmFtcDtsaXN0X3VpZHM9MTExMzY2OTE8L3VybD48L3JlbGF0ZWQtdXJscz48L3VybHM+PGxh

bmd1YWdlPmVuZzwvbGFuZ3VhZ2U+PC9yZWNvcmQ+PC9DaXRlPjwvRW5kTm90ZT4AAAA=

ADDIN EN.CITE PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5Nb3NzPC9BdXRob3I+PFllYXI+MjAwMDwvWWVhcj48UmVj

TnVtPjM2Mzk8L1JlY051bT48cmVjb3JkPjxyZWMtbnVtYmVyPjM2Mzk8L3JlYy1udW1iZXI+PGZv

cmVpZ24ta2V5cz48a2V5IGFwcD0iRU4iIGRiLWlkPSJmcjB0enBwMnY5eHRwb2V3YTUycDBldnFz

ejJkdnZzdDlzZDAiPjM2Mzk8L2tleT48L2ZvcmVpZ24ta2V5cz48cmVmLXR5cGUgbmFtZT0iSm91

cm5hbCBBcnRpY2xlIj4xNzwvcmVmLXR5cGU+PGNvbnRyaWJ1dG9ycz48YXV0aG9ycz48YXV0aG9y

Pk1vc3MsIEEuIEouPC9hdXRob3I+PGF1dGhvcj5aYXJlYmEsIFcuPC9hdXRob3I+PGF1dGhvcj5I

YWxsLCBXLiBKLjwvYXV0aG9yPjxhdXRob3I+U2Nod2FydHosIFAuIEouPC9hdXRob3I+PGF1dGhv

cj5DcmFtcHRvbiwgUi4gUy48L2F1dGhvcj48YXV0aG9yPkJlbmhvcmluLCBKLjwvYXV0aG9yPjxh

dXRob3I+VmluY2VudCwgRy4gTS48L2F1dGhvcj48YXV0aG9yPkxvY2F0aSwgRS4gSC48L2F1dGhv

cj48YXV0aG9yPlByaW9yaSwgUy4gRy48L2F1dGhvcj48YXV0aG9yPk5hcG9saXRhbm8sIEMuPC9h

dXRob3I+PGF1dGhvcj5NZWRpbmEsIEEuPC9hdXRob3I+PGF1dGhvcj5aaGFuZywgTC48L2F1dGhv

cj48YXV0aG9yPlJvYmluc29uLCBKLiBMLjwvYXV0aG9yPjxhdXRob3I+VGltb3RoeSwgSy48L2F1

dGhvcj48YXV0aG9yPlRvd2JpbiwgSi4gQS48L2F1dGhvcj48YXV0aG9yPkFuZHJld3MsIE0uIEwu

PC9hdXRob3I+PC9hdXRob3JzPjwvY29udHJpYnV0b3JzPjxhdXRoLWFkZHJlc3M+RGVwYXJ0bWVu

dCBvZiBNZWRpY2luZSwgVW5pdmVyc2l0eSBvZiBSb2NoZXN0ZXIgU2Nob29sIG9mIE1lZGljaW5l

IGFuZCBEZW50aXN0cnksIE5ZIDE0NjQyLCBVU0EuIGhlYXJ0YWptQGhlYXJ0LnJvY2hlc3Rlci5l

ZHU8L2F1dGgtYWRkcmVzcz48dGl0bGVzPjx0aXRsZT5FZmZlY3RpdmVuZXNzIGFuZCBsaW1pdGF0

aW9ucyBvZiBiZXRhLWJsb2NrZXIgdGhlcmFweSBpbiBjb25nZW5pdGFsIGxvbmctUVQgc3luZHJv

bWU8L3RpdGxlPjxzZWNvbmRhcnktdGl0bGU+Q2lyY3VsYXRpb248L3NlY29uZGFyeS10aXRsZT48

L3RpdGxlcz48cGVyaW9kaWNhbD48ZnVsbC10aXRsZT5DaXJjdWxhdGlvbjwvZnVsbC10aXRsZT48

L3BlcmlvZGljYWw+PHBhZ2VzPjYxNi0yMzwvcGFnZXM+PHZvbHVtZT4xMDE8L3ZvbHVtZT48bnVt

YmVyPjY8L251bWJlcj48ZWRpdGlvbj4yMDAwLzAyLzE1PC9lZGl0aW9uPjxrZXl3b3Jkcz48a2V5

d29yZD5BZG9sZXNjZW50PC9rZXl3b3JkPjxrZXl3b3JkPkFkcmVuZXJnaWMgYmV0YS1BbnRhZ29u

aXN0cy8qYWRtaW5pc3RyYXRpb24gJmFtcDsgZG9zYWdlL2FkdmVyc2UgZWZmZWN0czwva2V5d29y

ZD48a2V5d29yZD5BZHVsdDwva2V5d29yZD48a2V5d29yZD5BdGVub2xvbC9hZG1pbmlzdHJhdGlv

biAmYW1wOyBkb3NhZ2UvYWR2ZXJzZSBlZmZlY3RzPC9rZXl3b3JkPjxrZXl3b3JkPkNoaWxkPC9r

ZXl3b3JkPjxrZXl3b3JkPkNoaWxkLCBQcmVzY2hvb2w8L2tleXdvcmQ+PGtleXdvcmQ+RmVtYWxl

PC9rZXl3b3JkPjxrZXl3b3JkPkh1bWFuczwva2V5d29yZD48a2V5d29yZD5JbmZhbnQ8L2tleXdv

cmQ+PGtleXdvcmQ+TG9uZyBRVCBTeW5kcm9tZS9jb25nZW5pdGFsLypkcnVnIHRoZXJhcHkvcGh5

c2lvcGF0aG9sb2d5PC9rZXl3b3JkPjxrZXl3b3JkPk1hbGU8L2tleXdvcmQ+PGtleXdvcmQ+TWV0

b3Byb2xvbC9hZG1pbmlzdHJhdGlvbiAmYW1wOyBkb3NhZ2UvYWR2ZXJzZSBlZmZlY3RzPC9rZXl3

b3JkPjxrZXl3b3JkPk5hZG9sb2wvYWRtaW5pc3RyYXRpb24gJmFtcDsgZG9zYWdlL2FkdmVyc2Ug

ZWZmZWN0czwva2V5d29yZD48a2V5d29yZD5Qcm9wcmFub2xvbC9hZG1pbmlzdHJhdGlvbiAmYW1w

OyBkb3NhZ2UvYWR2ZXJzZSBlZmZlY3RzPC9rZXl3b3JkPjxrZXl3b3JkPlN1cnZpdmFsIEFuYWx5

c2lzPC9rZXl3b3JkPjwva2V5d29yZHM+PGRhdGVzPjx5ZWFyPjIwMDA8L3llYXI+PHB1Yi1kYXRl

cz48ZGF0ZT5GZWIgMTU8L2RhdGU+PC9wdWItZGF0ZXM+PC9kYXRlcz48aXNibj4xNTI0LTQ1Mzkg

KEVsZWN0cm9uaWMpPC9pc2JuPjxhY2Nlc3Npb24tbnVtPjEwNjczMjUzPC9hY2Nlc3Npb24tbnVt

Pjx1cmxzPjxyZWxhdGVkLXVybHM+PHVybD5odHRwOi8vd3d3Lm5jYmkubmxtLm5paC5nb3YvZW50

cmV6L3F1ZXJ5LmZjZ2k/Y21kPVJldHJpZXZlJmFtcDtkYj1QdWJNZWQmYW1wO2RvcHQ9Q2l0YXRp

b24mYW1wO2xpc3RfdWlkcz0xMDY3MzI1MzwvdXJsPjwvcmVsYXRlZC11cmxzPjwvdXJscz48bGFu

Z3VhZ2U+ZW5nPC9sYW5ndWFnZT48L3JlY29yZD48L0NpdGU+PENpdGU+PEF1dGhvcj5Qcmlvcmk8

L0F1dGhvcj48WWVhcj4yMDA0PC9ZZWFyPjxSZWNOdW0+MjE0NDwvUmVjTnVtPjxyZWNvcmQ+PHJl

Yy1udW1iZXI+MjE0NDwvcmVjLW51bWJlcj48Zm9yZWlnbi1rZXlzPjxrZXkgYXBwPSJFTiIgZGIt

aWQ9ImZyMHR6cHAydjl4dHBvZXdhNTJwMGV2cXN6MmR2dnN0OXNkMCI+MjE0NDwva2V5PjwvZm9y

ZWlnbi1rZXlzPjxyZWYtdHlwZSBuYW1lPSJKb3VybmFsIEFydGljbGUiPjE3PC9yZWYtdHlwZT48

Y29udHJpYnV0b3JzPjxhdXRob3JzPjxhdXRob3I+UHJpb3JpLCBTLiBHLjwvYXV0aG9yPjxhdXRo

b3I+TmFwb2xpdGFubywgQy48L2F1dGhvcj48YXV0aG9yPlNjaHdhcnR6LCBQLiBKLjwvYXV0aG9y

PjxhdXRob3I+R3JpbGxvLCBNLjwvYXV0aG9yPjxhdXRob3I+QmxvaXNlLCBSLjwvYXV0aG9yPjxh

dXRob3I+Um9uY2hldHRpLCBFLjwvYXV0aG9yPjxhdXRob3I+TW9uY2Fsdm8sIEMuPC9hdXRob3I+

PGF1dGhvcj5UdWxpcGFuaSwgQy48L2F1dGhvcj48YXV0aG9yPlZlaWEsIEEuPC9hdXRob3I+PGF1

dGhvcj5Cb3R0ZWxsaSwgRy48L2F1dGhvcj48YXV0aG9yPk5hc3RvbGksIEouPC9hdXRob3I+PC9h

dXRob3JzPjwvY29udHJpYnV0b3JzPjxhdXRoLWFkZHJlc3M+TW9sZWN1bGFyIENhcmRpb2xvZ3ks

IElSQ0NTIEZvbmRhemlvbmUgTWF1Z2VyaSwgVW5pdmVyc2l0eSBvZiBQYXZpYSwgUGF2aWEsIEl0

YWx5LiBzcHJpb3JpQGZzbS5pdDwvYXV0aC1hZGRyZXNzPjx0aXRsZXM+PHRpdGxlPkFzc29jaWF0

aW9uIG9mIGxvbmcgUVQgc3luZHJvbWUgbG9jaSBhbmQgY2FyZGlhYyBldmVudHMgYW1vbmcgcGF0

aWVudHMgdHJlYXRlZCB3aXRoIGJldGEtYmxvY2tlcnM8L3RpdGxlPjxzZWNvbmRhcnktdGl0bGU+

SkFNQTwvc2Vjb25kYXJ5LXRpdGxlPjwvdGl0bGVzPjxwZXJpb2RpY2FsPjxmdWxsLXRpdGxlPkpB

TUE8L2Z1bGwtdGl0bGU+PC9wZXJpb2RpY2FsPjxwYWdlcz4xMzQxLTQ8L3BhZ2VzPjx2b2x1bWU+

MjkyPC92b2x1bWU+PG51bWJlcj4xMTwvbnVtYmVyPjxlZGl0aW9uPjIwMDQvMDkvMTY8L2VkaXRp

b24+PGtleXdvcmRzPjxrZXl3b3JkPkFkcmVuZXJnaWMgYmV0YS1BbnRhZ29uaXN0cy8qdGhlcmFw

ZXV0aWMgdXNlPC9rZXl3b3JkPjxrZXl3b3JkPkFkdWx0PC9rZXl3b3JkPjxrZXl3b3JkPkRpc2Vh

c2UgUHJvZ3Jlc3Npb248L2tleXdvcmQ+PGtleXdvcmQ+RXRoZXItQS1Hby1HbyBQb3Rhc3NpdW0g

Q2hhbm5lbHM8L2tleXdvcmQ+PGtleXdvcmQ+R2Vub3R5cGU8L2tleXdvcmQ+PGtleXdvcmQ+SHVt

YW5zPC9rZXl3b3JkPjxrZXl3b3JkPktDTlEgUG90YXNzaXVtIENoYW5uZWxzPC9rZXl3b3JkPjxr

ZXl3b3JkPktDTlExIFBvdGFzc2l1bSBDaGFubmVsPC9rZXl3b3JkPjxrZXl3b3JkPkxvbmcgUVQg

U3luZHJvbWUvKmRydWcgdGhlcmFweS8qZ2VuZXRpY3MvcGh5c2lvcGF0aG9sb2d5PC9rZXl3b3Jk

PjxrZXl3b3JkPlBvdGFzc2l1bSBDaGFubmVscy9nZW5ldGljczwva2V5d29yZD48a2V5d29yZD4q

UG90YXNzaXVtIENoYW5uZWxzLCBWb2x0YWdlLUdhdGVkPC9rZXl3b3JkPjxrZXl3b3JkPlNvZGl1

bSBDaGFubmVscy9nZW5ldGljczwva2V5d29yZD48a2V5d29yZD5TdXJ2aXZhbCBBbmFseXNpczwv

a2V5d29yZD48a2V5d29yZD5UcmVhdG1lbnQgT3V0Y29tZTwva2V5d29yZD48L2tleXdvcmRzPjxk

YXRlcz48eWVhcj4yMDA0PC95ZWFyPjxwdWItZGF0ZXM+PGRhdGU+U2VwIDE1PC9kYXRlPjwvcHVi

LWRhdGVzPjwvZGF0ZXM+PGlzYm4+MTUzOC0zNTk4IChFbGVjdHJvbmljKTwvaXNibj48YWNjZXNz

aW9uLW51bT4xNTM2NzU1NjwvYWNjZXNzaW9uLW51bT48dXJscz48cmVsYXRlZC11cmxzPjx1cmw+

aHR0cDovL3d3dy5uY2JpLm5sbS5uaWguZ292L2VudHJlei9xdWVyeS5mY2dpP2NtZD1SZXRyaWV2

ZSZhbXA7ZGI9UHViTWVkJmFtcDtkb3B0PUNpdGF0aW9uJmFtcDtsaXN0X3VpZHM9MTUzNjc1NTY8

L3VybD48L3JlbGF0ZWQtdXJscz48L3VybHM+PGVsZWN0cm9uaWMtcmVzb3VyY2UtbnVtPjEwLjEw

MDEvamFtYS4yOTIuMTEuMTM0MSYjeEQ7MjkyLzExLzEzNDEgW3BpaV08L2VsZWN0cm9uaWMtcmVz

b3VyY2UtbnVtPjxsYW5ndWFnZT5lbmc8L2xhbmd1YWdlPjwvcmVjb3JkPjwvQ2l0ZT48Q2l0ZT48

QXV0aG9yPlNjaHdhcnR6PC9BdXRob3I+PFllYXI+MjAwMTwvWWVhcj48UmVjTnVtPjM0MTE8L1Jl

Y051bT48cmVjb3JkPjxyZWMtbnVtYmVyPjM0MTE8L3JlYy1udW1iZXI+PGZvcmVpZ24ta2V5cz48

a2V5IGFwcD0iRU4iIGRiLWlkPSJmcjB0enBwMnY5eHRwb2V3YTUycDBldnFzejJkdnZzdDlzZDAi

PjM0MTE8L2tleT48L2ZvcmVpZ24ta2V5cz48cmVmLXR5cGUgbmFtZT0iSm91cm5hbCBBcnRpY2xl

Ij4xNzwvcmVmLXR5cGU+PGNvbnRyaWJ1dG9ycz48YXV0aG9ycz48YXV0aG9yPlNjaHdhcnR6LCBQ

LiBKLjwvYXV0aG9yPjxhdXRob3I+UHJpb3JpLCBTLiBHLjwvYXV0aG9yPjxhdXRob3I+U3Bhenpv

bGluaSwgQy48L2F1dGhvcj48YXV0aG9yPk1vc3MsIEEuIEouPC9hdXRob3I+PGF1dGhvcj5WaW5j

ZW50LCBHLiBNLjwvYXV0aG9yPjxhdXRob3I+TmFwb2xpdGFubywgQy48L2F1dGhvcj48YXV0aG9y

PkRlbmpveSwgSS48L2F1dGhvcj48YXV0aG9yPkd1aWNoZW5leSwgUC48L2F1dGhvcj48YXV0aG9y

PkJyZWl0aGFyZHQsIEcuPC9hdXRob3I+PGF1dGhvcj5LZWF0aW5nLCBNLiBULjwvYXV0aG9yPjxh

dXRob3I+VG93YmluLCBKLiBBLjwvYXV0aG9yPjxhdXRob3I+QmVnZ3MsIEEuIEguPC9hdXRob3I+

PGF1dGhvcj5CcmluaywgUC48L2F1dGhvcj48YXV0aG9yPldpbGRlLCBBLiBBLjwvYXV0aG9yPjxh

dXRob3I+VG9pdm9uZW4sIEwuPC9hdXRob3I+PGF1dGhvcj5aYXJlYmEsIFcuPC9hdXRob3I+PGF1

dGhvcj5Sb2JpbnNvbiwgSi4gTC48L2F1dGhvcj48YXV0aG9yPlRpbW90aHksIEsuIFcuPC9hdXRo

b3I+PGF1dGhvcj5Db3JmaWVsZCwgVi48L2F1dGhvcj48YXV0aG9yPldhdHRhbmFzaXJpY2hhaWdv

b24sIEQuPC9hdXRob3I+PGF1dGhvcj5Db3JiZXR0LCBDLjwvYXV0aG9yPjxhdXRob3I+SGF2ZXJr

YW1wLCBXLjwvYXV0aG9yPjxhdXRob3I+U2NodWx6ZS1CYWhyLCBFLjwvYXV0aG9yPjxhdXRob3I+

TGVobWFubiwgTS4gSC48L2F1dGhvcj48YXV0aG9yPlNjaHdhcnR6LCBLLjwvYXV0aG9yPjxhdXRo

b3I+Q291bWVsLCBQLjwvYXV0aG9yPjxhdXRob3I+QmxvaXNlLCBSLjwvYXV0aG9yPjwvYXV0aG9y

cz48L2NvbnRyaWJ1dG9ycz48YXV0aC1hZGRyZXNzPkRlcGFydG1lbnQgb2YgQ2FyZGlvbG9neSwg

UG9saWNsaW5pY28gUy4gTWF0dGVvIElSQ0NTIGFuZCBVbml2ZXJzaXR5IG9mIFBhdmlhLCBQYXZp

YSwgSXRhbHkuIFBKUVRAY29tcHVzZXJ2ZS5jb208L2F1dGgtYWRkcmVzcz48dGl0bGVzPjx0aXRs

ZT5HZW5vdHlwZS1waGVub3R5cGUgY29ycmVsYXRpb24gaW4gdGhlIGxvbmctUVQgc3luZHJvbWU6

IGdlbmUtc3BlY2lmaWMgdHJpZ2dlcnMgZm9yIGxpZmUtdGhyZWF0ZW5pbmcgYXJyaHl0aG1pYXM8

L3RpdGxlPjxzZWNvbmRhcnktdGl0bGU+Q2lyY3VsYXRpb248L3NlY29uZGFyeS10aXRsZT48L3Rp

dGxlcz48cGVyaW9kaWNhbD48ZnVsbC10aXRsZT5DaXJjdWxhdGlvbjwvZnVsbC10aXRsZT48L3Bl

cmlvZGljYWw+PHBhZ2VzPjg5LTk1PC9wYWdlcz48dm9sdW1lPjEwMzwvdm9sdW1lPjxudW1iZXI+

MTwvbnVtYmVyPjxlZGl0aW9uPjIwMDEvMDEvMDQ8L2VkaXRpb24+PGtleXdvcmRzPjxrZXl3b3Jk

PkFkcmVuZXJnaWMgYmV0YS1BbnRhZ29uaXN0cy90aGVyYXBldXRpYyB1c2U8L2tleXdvcmQ+PGtl

eXdvcmQ+QWR1bHQ8L2tleXdvcmQ+PGtleXdvcmQ+QXJyaHl0aG1pYXMsIENhcmRpYWMvZXRpb2xv

Z3kvZ2VuZXRpY3MvcGh5c2lvcGF0aG9sb2d5PC9rZXl3b3JkPjxrZXl3b3JkPkRlYXRoLCBTdWRk

ZW4sIENhcmRpYWMvZXRpb2xvZ3k8L2tleXdvcmQ+PGtleXdvcmQ+RWxlY3Ryb2NhcmRpb2dyYXBo

eTwva2V5d29yZD48a2V5d29yZD5FbW90aW9uczwva2V5d29yZD48a2V5d29yZD5FeGVyY2lzZTwv

a2V5d29yZD48a2V5d29yZD5GZW1hbGU8L2tleXdvcmQ+PGtleXdvcmQ+R2Vub3R5cGU8L2tleXdv

cmQ+PGtleXdvcmQ+SHVtYW5zPC9rZXl3b3JkPjxrZXl3b3JkPklvbiBDaGFubmVscy9nZW5ldGlj

czwva2V5d29yZD48a2V5d29yZD5Mb25nIFFUIFN5bmRyb21lL2NsYXNzaWZpY2F0aW9uL2RpYWdu

b3Npcy9kcnVnPC9rZXl3b3JkPjxrZXl3b3JkPnRoZXJhcHkvKmdlbmV0aWNzL3BoeXNpb3BhdGhv

bG9neTwva2V5d29yZD48a2V5d29yZD5NYWxlPC9rZXl3b3JkPjxrZXl3b3JkPlBoZW5vdHlwZTwv

a2V5d29yZD48a2V5d29yZD5TZXggRmFjdG9yczwva2V5d29yZD48a2V5d29yZD5TbGVlcDwva2V5

d29yZD48a2V5d29yZD5TdXJ2aXZhbCBSYXRlPC9rZXl3b3JkPjxrZXl3b3JkPlN5bmNvcGUvZXRp

b2xvZ3k8L2tleXdvcmQ+PC9rZXl3b3Jkcz48ZGF0ZXM+PHllYXI+MjAwMTwveWVhcj48cHViLWRh

dGVzPjxkYXRlPkphbiAyPC9kYXRlPjwvcHViLWRhdGVzPjwvZGF0ZXM+PGlzYm4+MTUyNC00NTM5

IChFbGVjdHJvbmljKTwvaXNibj48YWNjZXNzaW9uLW51bT4xMTEzNjY5MTwvYWNjZXNzaW9uLW51

bT48dXJscz48cmVsYXRlZC11cmxzPjx1cmw+aHR0cDovL3d3dy5uY2JpLm5sbS5uaWguZ292L2Vu

dHJlei9xdWVyeS5mY2dpP2NtZD1SZXRyaWV2ZSZhbXA7ZGI9UHViTWVkJmFtcDtkb3B0PUNpdGF0

aW9uJmFtcDtsaXN0X3VpZHM9MTExMzY2OTE8L3VybD48L3JlbGF0ZWQtdXJscz48L3VybHM+PGxh

bmd1YWdlPmVuZzwvbGFuZ3VhZ2U+PC9yZWNvcmQ+PC9DaXRlPjwvRW5kTm90ZT4AAAA=

ADDIN EN.CITE.DATA 29-31, but are particularly effective in Type 1 LQTSPEVuZE5vdGU+PENpdGU+PEF1dGhvcj5WaW5jZW50PC9BdXRob3I+PFllYXI+MjAwOTwvWWVhcj48

UmVjTnVtPjMwMTwvUmVjTnVtPjxyZWNvcmQ+PHJlYy1udW1iZXI+MzAxPC9yZWMtbnVtYmVyPjxm

b3JlaWduLWtleXM+PGtleSBhcHA9IkVOIiBkYi1pZD0iZnIwdHpwcDJ2OXh0cG9ld2E1MnAwZXZx

c3oyZHZ2c3Q5c2QwIj4zMDE8L2tleT48L2ZvcmVpZ24ta2V5cz48cmVmLXR5cGUgbmFtZT0iSm91

cm5hbCBBcnRpY2xlIj4xNzwvcmVmLXR5cGU+PGNvbnRyaWJ1dG9ycz48YXV0aG9ycz48YXV0aG9y

PlZpbmNlbnQsIEcuIE0uPC9hdXRob3I+PGF1dGhvcj5TY2h3YXJ0eiwgUC4gSi48L2F1dGhvcj48

YXV0aG9yPkRlbmpveSwgSS48L2F1dGhvcj48YXV0aG9yPlN3YW4sIEguPC9hdXRob3I+PGF1dGhv

cj5CaXRoZWxsLCBDLjwvYXV0aG9yPjxhdXRob3I+U3BhenpvbGluaSwgQy48L2F1dGhvcj48YXV0

aG9yPkNyb3R0aSwgTC48L2F1dGhvcj48YXV0aG9yPlBpaXBwbywgSy48L2F1dGhvcj48YXV0aG9y

Pkx1cG9nbGF6b2ZmLCBKLiBNLjwvYXV0aG9yPjxhdXRob3I+VmlsbGFpbiwgRS48L2F1dGhvcj48

YXV0aG9yPlByaW9yaSwgUy4gRy48L2F1dGhvcj48YXV0aG9yPk5hcG9saXRhbm8sIEMuPC9hdXRo

b3I+PGF1dGhvcj5aaGFuZywgTC48L2F1dGhvcj48L2F1dGhvcnM+PC9jb250cmlidXRvcnM+PGF1

dGgtYWRkcmVzcz5EZXBhcnRtZW50IG9mIE1lZGljaW5lLCBMRFMgSG9zcGl0YWwgYW5kIFVuaXZl

cnNpdHkgb2YgVXRhaCwgU2FsdCBMYWtlIENpdHksIFVULCBVU0EuIGcubWljaGFlbC52aW5jZW50

QGludGVybW91bnRhaW5tYWlsLm9yZzwvYXV0aC1hZGRyZXNzPjx0aXRsZXM+PHRpdGxlPkhpZ2gg

ZWZmaWNhY3kgb2YgYmV0YS1ibG9ja2VycyBpbiBsb25nLVFUIHN5bmRyb21lIHR5cGUgMTogY29u

dHJpYnV0aW9uIG9mIG5vbmNvbXBsaWFuY2UgYW5kIFFULXByb2xvbmdpbmcgZHJ1Z3MgdG8gdGhl

IG9jY3VycmVuY2Ugb2YgYmV0YS1ibG9ja2VyIHRyZWF0bWVudCAmcXVvdDtmYWlsdXJlcyZxdW90

OzwvdGl0bGU+PHNlY29uZGFyeS10aXRsZT5DaXJjdWxhdGlvbjwvc2Vjb25kYXJ5LXRpdGxlPjwv

dGl0bGVzPjxwZXJpb2RpY2FsPjxmdWxsLXRpdGxlPkNpcmN1bGF0aW9uPC9mdWxsLXRpdGxlPjwv

cGVyaW9kaWNhbD48cGFnZXM+MjE1LTIxPC9wYWdlcz48dm9sdW1lPjExOTwvdm9sdW1lPjxudW1i

ZXI+MjwvbnVtYmVyPjxlZGl0aW9uPjIwMDkvMDEvMDI8L2VkaXRpb24+PGtleXdvcmRzPjxrZXl3

b3JkPkFkb2xlc2NlbnQ8L2tleXdvcmQ+PGtleXdvcmQ+QWRyZW5lcmdpYyBiZXRhLUFudGFnb25p

c3RzL3BoYXJtYWNva2luZXRpY3MvKnRoZXJhcGV1dGljIHVzZTwva2V5d29yZD48a2V5d29yZD5B

ZHVsdDwva2V5d29yZD48a2V5d29yZD5GZW1hbGU8L2tleXdvcmQ+PGtleXdvcmQ+Rm9sbG93LVVw

IFN0dWRpZXM8L2tleXdvcmQ+PGtleXdvcmQ+SHVtYW5zPC9rZXl3b3JkPjxrZXl3b3JkPk1hbGU8

L2tleXdvcmQ+PGtleXdvcmQ+TWlkZGxlIEFnZWQ8L2tleXdvcmQ+PGtleXdvcmQ+TXV0YXRpb24v

Z2VuZXRpY3M8L2tleXdvcmQ+PGtleXdvcmQ+KlBhdGllbnQgQ29tcGxpYW5jZTwva2V5d29yZD48

a2V5d29yZD5QaGFybWFjZXV0aWNhbCBQcmVwYXJhdGlvbnMvKmFkdmVyc2UgZWZmZWN0cy9tZXRh

Ym9saXNtPC9rZXl3b3JkPjxrZXl3b3JkPlJldHJvc3BlY3RpdmUgU3R1ZGllczwva2V5d29yZD48

a2V5d29yZD5Sb21hbm8tV2FyZCBTeW5kcm9tZS8qZHJ1ZyB0aGVyYXB5L2dlbmV0aWNzL21vcnRh

bGl0eTwva2V5d29yZD48a2V5d29yZD5UcmVhdG1lbnQgRmFpbHVyZTwva2V5d29yZD48a2V5d29y

ZD5Zb3VuZyBBZHVsdDwva2V5d29yZD48L2tleXdvcmRzPjxkYXRlcz48eWVhcj4yMDA5PC95ZWFy

PjxwdWItZGF0ZXM+PGRhdGU+SmFuIDIwPC9kYXRlPjwvcHViLWRhdGVzPjwvZGF0ZXM+PGlzYm4+

MTUyNC00NTM5IChFbGVjdHJvbmljKTwvaXNibj48YWNjZXNzaW9uLW51bT4xOTExODI1ODwvYWNj

ZXNzaW9uLW51bT48dXJscz48cmVsYXRlZC11cmxzPjx1cmw+aHR0cDovL3d3dy5uY2JpLm5sbS5u

aWguZ292L2VudHJlei9xdWVyeS5mY2dpP2NtZD1SZXRyaWV2ZSZhbXA7ZGI9UHViTWVkJmFtcDtk

b3B0PUNpdGF0aW9uJmFtcDtsaXN0X3VpZHM9MTkxMTgyNTg8L3VybD48L3JlbGF0ZWQtdXJscz48

L3VybHM+PGVsZWN0cm9uaWMtcmVzb3VyY2UtbnVtPkNJUkNVTEFUSU9OQUhBLjEwOC43NzI1MzMg

W3BpaV0mI3hEOzEwLjExNjEvQ0lSQ1VMQVRJT05BSEEuMTA4Ljc3MjUzMzwvZWxlY3Ryb25pYy1y

ZXNvdXJjZS1udW0+PGxhbmd1YWdlPmVuZzwvbGFuZ3VhZ2U+PC9yZWNvcmQ+PC9DaXRlPjwvRW5k

Tm90ZT4AAD==

ADDIN EN.CITE PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5WaW5jZW50PC9BdXRob3I+PFllYXI+MjAwOTwvWWVhcj48

UmVjTnVtPjMwMTwvUmVjTnVtPjxyZWNvcmQ+PHJlYy1udW1iZXI+MzAxPC9yZWMtbnVtYmVyPjxm

b3JlaWduLWtleXM+PGtleSBhcHA9IkVOIiBkYi1pZD0iZnIwdHpwcDJ2OXh0cG9ld2E1MnAwZXZx

c3oyZHZ2c3Q5c2QwIj4zMDE8L2tleT48L2ZvcmVpZ24ta2V5cz48cmVmLXR5cGUgbmFtZT0iSm91

cm5hbCBBcnRpY2xlIj4xNzwvcmVmLXR5cGU+PGNvbnRyaWJ1dG9ycz48YXV0aG9ycz48YXV0aG9y

PlZpbmNlbnQsIEcuIE0uPC9hdXRob3I+PGF1dGhvcj5TY2h3YXJ0eiwgUC4gSi48L2F1dGhvcj48

YXV0aG9yPkRlbmpveSwgSS48L2F1dGhvcj48YXV0aG9yPlN3YW4sIEguPC9hdXRob3I+PGF1dGhv

cj5CaXRoZWxsLCBDLjwvYXV0aG9yPjxhdXRob3I+U3BhenpvbGluaSwgQy48L2F1dGhvcj48YXV0

aG9yPkNyb3R0aSwgTC48L2F1dGhvcj48YXV0aG9yPlBpaXBwbywgSy48L2F1dGhvcj48YXV0aG9y

Pkx1cG9nbGF6b2ZmLCBKLiBNLjwvYXV0aG9yPjxhdXRob3I+VmlsbGFpbiwgRS48L2F1dGhvcj48

YXV0aG9yPlByaW9yaSwgUy4gRy48L2F1dGhvcj48YXV0aG9yPk5hcG9saXRhbm8sIEMuPC9hdXRo

b3I+PGF1dGhvcj5aaGFuZywgTC48L2F1dGhvcj48L2F1dGhvcnM+PC9jb250cmlidXRvcnM+PGF1

dGgtYWRkcmVzcz5EZXBhcnRtZW50IG9mIE1lZGljaW5lLCBMRFMgSG9zcGl0YWwgYW5kIFVuaXZl

cnNpdHkgb2YgVXRhaCwgU2FsdCBMYWtlIENpdHksIFVULCBVU0EuIGcubWljaGFlbC52aW5jZW50

QGludGVybW91bnRhaW5tYWlsLm9yZzwvYXV0aC1hZGRyZXNzPjx0aXRsZXM+PHRpdGxlPkhpZ2gg

ZWZmaWNhY3kgb2YgYmV0YS1ibG9ja2VycyBpbiBsb25nLVFUIHN5bmRyb21lIHR5cGUgMTogY29u

dHJpYnV0aW9uIG9mIG5vbmNvbXBsaWFuY2UgYW5kIFFULXByb2xvbmdpbmcgZHJ1Z3MgdG8gdGhl

IG9jY3VycmVuY2Ugb2YgYmV0YS1ibG9ja2VyIHRyZWF0bWVudCAmcXVvdDtmYWlsdXJlcyZxdW90

OzwvdGl0bGU+PHNlY29uZGFyeS10aXRsZT5DaXJjdWxhdGlvbjwvc2Vjb25kYXJ5LXRpdGxlPjwv

dGl0bGVzPjxwZXJpb2RpY2FsPjxmdWxsLXRpdGxlPkNpcmN1bGF0aW9uPC9mdWxsLXRpdGxlPjwv

cGVyaW9kaWNhbD48cGFnZXM+MjE1LTIxPC9wYWdlcz48dm9sdW1lPjExOTwvdm9sdW1lPjxudW1i

ZXI+MjwvbnVtYmVyPjxlZGl0aW9uPjIwMDkvMDEvMDI8L2VkaXRpb24+PGtleXdvcmRzPjxrZXl3

b3JkPkFkb2xlc2NlbnQ8L2tleXdvcmQ+PGtleXdvcmQ+QWRyZW5lcmdpYyBiZXRhLUFudGFnb25p

c3RzL3BoYXJtYWNva2luZXRpY3MvKnRoZXJhcGV1dGljIHVzZTwva2V5d29yZD48a2V5d29yZD5B

ZHVsdDwva2V5d29yZD48a2V5d29yZD5GZW1hbGU8L2tleXdvcmQ+PGtleXdvcmQ+Rm9sbG93LVVw

IFN0dWRpZXM8L2tleXdvcmQ+PGtleXdvcmQ+SHVtYW5zPC9rZXl3b3JkPjxrZXl3b3JkPk1hbGU8

L2tleXdvcmQ+PGtleXdvcmQ+TWlkZGxlIEFnZWQ8L2tleXdvcmQ+PGtleXdvcmQ+TXV0YXRpb24v

Z2VuZXRpY3M8L2tleXdvcmQ+PGtleXdvcmQ+KlBhdGllbnQgQ29tcGxpYW5jZTwva2V5d29yZD48

a2V5d29yZD5QaGFybWFjZXV0aWNhbCBQcmVwYXJhdGlvbnMvKmFkdmVyc2UgZWZmZWN0cy9tZXRh

Ym9saXNtPC9rZXl3b3JkPjxrZXl3b3JkPlJldHJvc3BlY3RpdmUgU3R1ZGllczwva2V5d29yZD48

a2V5d29yZD5Sb21hbm8tV2FyZCBTeW5kcm9tZS8qZHJ1ZyB0aGVyYXB5L2dlbmV0aWNzL21vcnRh

bGl0eTwva2V5d29yZD48a2V5d29yZD5UcmVhdG1lbnQgRmFpbHVyZTwva2V5d29yZD48a2V5d29y

ZD5Zb3VuZyBBZHVsdDwva2V5d29yZD48L2tleXdvcmRzPjxkYXRlcz48eWVhcj4yMDA5PC95ZWFy

PjxwdWItZGF0ZXM+PGRhdGU+SmFuIDIwPC9kYXRlPjwvcHViLWRhdGVzPjwvZGF0ZXM+PGlzYm4+

MTUyNC00NTM5IChFbGVjdHJvbmljKTwvaXNibj48YWNjZXNzaW9uLW51bT4xOTExODI1ODwvYWNj

ZXNzaW9uLW51bT48dXJscz48cmVsYXRlZC11cmxzPjx1cmw+aHR0cDovL3d3dy5uY2JpLm5sbS5u

aWguZ292L2VudHJlei9xdWVyeS5mY2dpP2NtZD1SZXRyaWV2ZSZhbXA7ZGI9UHViTWVkJmFtcDtk

b3B0PUNpdGF0aW9uJmFtcDtsaXN0X3VpZHM9MTkxMTgyNTg8L3VybD48L3JlbGF0ZWQtdXJscz48

L3VybHM+PGVsZWN0cm9uaWMtcmVzb3VyY2UtbnVtPkNJUkNVTEFUSU9OQUhBLjEwOC43NzI1MzMg

W3BpaV0mI3hEOzEwLjExNjEvQ0lSQ1VMQVRJT05BSEEuMTA4Ljc3MjUzMzwvZWxlY3Ryb25pYy1y

ZXNvdXJjZS1udW0+PGxhbmd1YWdlPmVuZzwvbGFuZ3VhZ2U+PC9yZWNvcmQ+PC9DaXRlPjwvRW5k

Tm90ZT4AAD==

ADDIN EN.CITE.DATA 32.Beta-blockers tend to be ineffective in LQT3. This is unsurprising given that arrhythmias tend to occur after exercise in LQT1, whereas they tend to occur at rest in LQT3. LQT3 is characterised by a gain of function of the sodium channel SCN5A; mexiletene, a sodium channel blocker, appears to be effective in LQT3 ADDIN EN.CITE <EndNote><Cite><Author>Nademanee</Author><Year>2009</Year><RecNum>5425</RecNum><record><rec-number>5425</rec-number><foreign-keys><key app="EN" db-id="fr0tzpp2v9xtpoewa52p0evqsz2dvvst9sd0">5425</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Nademanee, K.</author></authors></contributors><titles><title> Genotype-Phenotype Relationship in the Long QT Syndrome: Brimming with Knowledge but Thirsting for a Therapeutic Solution.</title><secondary-title>J Am Coll Cardiol</secondary-title></titles><periodical><full-title>J Am Coll Cardiol</full-title></periodical><pages>2063-4.</pages><volume>54</volume><dates><year>2009</year></dates><urls></urls></record></Cite></EndNote>33. In the USA over-the-counter sales of AEDs (Automatic external defibrillators) are approved for home use in patients with high risk inherited arrhythmias such as LQTSPEVuZE5vdGU+PENpdGU+PEF1dGhvcj5aaXBlczwvQXV0aG9yPjxZZWFyPjIwMDY8L1llYXI+PFJl

Y051bT41NDI3PC9SZWNOdW0+PHJlY29yZD48cmVjLW51bWJlcj41NDI3PC9yZWMtbnVtYmVyPjxm

b3JlaWduLWtleXM+PGtleSBhcHA9IkVOIiBkYi1pZD0iZnIwdHpwcDJ2OXh0cG9ld2E1MnAwZXZx

c3oyZHZ2c3Q5c2QwIj41NDI3PC9rZXk+PC9mb3JlaWduLWtleXM+PHJlZi10eXBlIG5hbWU9Ikpv

dXJuYWwgQXJ0aWNsZSI+MTc8L3JlZi10eXBlPjxjb250cmlidXRvcnM+PGF1dGhvcnM+PGF1dGhv

cj5aaXBlcywgRC4gUC48L2F1dGhvcj48YXV0aG9yPkNhbW0sIEEuIEouPC9hdXRob3I+PGF1dGhv

cj5Cb3JnZ3JlZmUsIE0uPC9hdXRob3I+PGF1dGhvcj5CdXh0b24sIEEuIEUuPC9hdXRob3I+PGF1

dGhvcj5DaGFpdG1hbiwgQi48L2F1dGhvcj48YXV0aG9yPkZyb21lciwgTS48L2F1dGhvcj48YXV0

aG9yPkdyZWdvcmF0b3MsIEcuPC9hdXRob3I+PGF1dGhvcj5LbGVpbiwgRy48L2F1dGhvcj48YXV0

aG9yPk1vc3MsIEEuIEouPC9hdXRob3I+PGF1dGhvcj5NeWVyYnVyZywgUi4gSi48L2F1dGhvcj48

YXV0aG9yPlByaW9yaSwgUy4gRy48L2F1dGhvcj48YXV0aG9yPlF1aW5vbmVzLCBNLiBBLjwvYXV0

aG9yPjxhdXRob3I+Um9kZW4sIEQuIE0uPC9hdXRob3I+PGF1dGhvcj5TaWxrYSwgTS4gSi48L2F1

dGhvcj48YXV0aG9yPlRyYWN5LCBDLjwvYXV0aG9yPjxhdXRob3I+U21pdGgsIFMuIEMuLCBKci48

L2F1dGhvcj48YXV0aG9yPkphY29icywgQS4gSy48L2F1dGhvcj48YXV0aG9yPkFkYW1zLCBDLiBE

LjwvYXV0aG9yPjxhdXRob3I+QW50bWFuLCBFLiBNLjwvYXV0aG9yPjxhdXRob3I+QW5kZXJzb24s

IEouIEwuPC9hdXRob3I+PGF1dGhvcj5IdW50LCBTLiBBLjwvYXV0aG9yPjxhdXRob3I+SGFscGVy

aW4sIEouIEwuPC9hdXRob3I+PGF1dGhvcj5OaXNoaW11cmEsIFIuPC9hdXRob3I+PGF1dGhvcj5P

cm5hdG8sIEouIFAuPC9hdXRob3I+PGF1dGhvcj5QYWdlLCBSLiBMLjwvYXV0aG9yPjxhdXRob3I+

UmllZ2VsLCBCLjwvYXV0aG9yPjxhdXRob3I+QmxhbmMsIEouIEouPC9hdXRob3I+PGF1dGhvcj5C

dWRhaiwgQS48L2F1dGhvcj48YXV0aG9yPkRlYW4sIFYuPC9hdXRob3I+PGF1dGhvcj5EZWNrZXJz

LCBKLiBXLjwvYXV0aG9yPjxhdXRob3I+RGVzcHJlcywgQy48L2F1dGhvcj48YXV0aG9yPkRpY2tz

dGVpbiwgSy48L2F1dGhvcj48YXV0aG9yPkxla2FraXMsIEouPC9hdXRob3I+PGF1dGhvcj5NY0dy

ZWdvciwgSy48L2F1dGhvcj48YXV0aG9yPk1ldHJhLCBNLjwvYXV0aG9yPjxhdXRob3I+TW9yYWlz

LCBKLjwvYXV0aG9yPjxhdXRob3I+T3N0ZXJzcGV5LCBBLjwvYXV0aG9yPjxhdXRob3I+VGFtYXJn

bywgSi4gTC48L2F1dGhvcj48YXV0aG9yPlphbW9yYW5vLCBKLiBMLjwvYXV0aG9yPjwvYXV0aG9y

cz48L2NvbnRyaWJ1dG9ycz48dGl0bGVzPjx0aXRsZT5BQ0MvQUhBL0VTQyAyMDA2IEd1aWRlbGlu

ZXMgZm9yIE1hbmFnZW1lbnQgb2YgUGF0aWVudHMgV2l0aCBWZW50cmljdWxhciBBcnJoeXRobWlh

cyBhbmQgdGhlIFByZXZlbnRpb24gb2YgU3VkZGVuIENhcmRpYWMgRGVhdGg6IGEgcmVwb3J0IG9m

IHRoZSBBbWVyaWNhbiBDb2xsZWdlIG9mIENhcmRpb2xvZ3kvQW1lcmljYW4gSGVhcnQgQXNzb2Np

YXRpb24gVGFzayBGb3JjZSBhbmQgdGhlIEV1cm9wZWFuIFNvY2lldHkgb2YgQ2FyZGlvbG9neSBD

b21taXR0ZWUgZm9yIFByYWN0aWNlIEd1aWRlbGluZXMgKHdyaXRpbmcgY29tbWl0dGVlIHRvIGRl

dmVsb3AgR3VpZGVsaW5lcyBmb3IgTWFuYWdlbWVudCBvZiBQYXRpZW50cyBXaXRoIFZlbnRyaWN1

bGFyIEFycmh5dGhtaWFzIGFuZCB0aGUgUHJldmVudGlvbiBvZiBTdWRkZW4gQ2FyZGlhYyBEZWF0

aCk6IGRldmVsb3BlZCBpbiBjb2xsYWJvcmF0aW9uIHdpdGggdGhlIEV1cm9wZWFuIEhlYXJ0IFJo

eXRobSBBc3NvY2lhdGlvbiBhbmQgdGhlIEhlYXJ0IFJoeXRobSBTb2NpZXR5PC90aXRsZT48c2Vj

b25kYXJ5LXRpdGxlPkNpcmN1bGF0aW9uPC9zZWNvbmRhcnktdGl0bGU+PC90aXRsZXM+PHBlcmlv

ZGljYWw+PGZ1bGwtdGl0bGU+Q2lyY3VsYXRpb248L2Z1bGwtdGl0bGU+PC9wZXJpb2RpY2FsPjxw

YWdlcz5lMzg1LTQ4NDwvcGFnZXM+PHZvbHVtZT4xMTQ8L3ZvbHVtZT48bnVtYmVyPjEwPC9udW1i

ZXI+PGtleXdvcmRzPjxrZXl3b3JkPkFtZXJpY2FuIEhlYXJ0IEFzc29jaWF0aW9uPC9rZXl3b3Jk

PjxrZXl3b3JkPkFycmh5dGhtaWEvKnRoZXJhcHk8L2tleXdvcmQ+PGtleXdvcmQ+RGVhdGgsIFN1

ZGRlbiwgQ2FyZGlhYy8qcHJldmVudGlvbiAmYW1wOyBjb250cm9sPC9rZXl3b3JkPjxrZXl3b3Jk

PkV1cm9wZTwva2V5d29yZD48a2V5d29yZD5IdW1hbnM8L2tleXdvcmQ+PGtleXdvcmQ+UXVhbGl0

eSBBc3N1cmFuY2UsIEhlYWx0aCBDYXJlPC9rZXl3b3JkPjxrZXl3b3JkPlNvY2lldGllcywgTWVk

aWNhbDwva2V5d29yZD48a2V5d29yZD5WZW50cmljdWxhciBEeXNmdW5jdGlvbi8qdGhlcmFweTwv

a2V5d29yZD48L2tleXdvcmRzPjxkYXRlcz48eWVhcj4yMDA2PC95ZWFyPjwvZGF0ZXM+PGFjY2Vz

c2lvbi1udW0+MTY5MzU5OTU8L2FjY2Vzc2lvbi1udW0+PHVybHM+PHJlbGF0ZWQtdXJscz48dXJs

Pmh0dHA6Ly93d3cubmNiaS5ubG0ubmloLmdvdi9lbnRyZXovcXVlcnkuZmNnaT9jbWQ9UmV0cmll

dmUmYW1wO2RiPVB1Yk1lZCZhbXA7ZG9wdD1DaXRhdGlvbiZhbXA7bGlzdF91aWRzPTE2OTM1OTk1

PC91cmw+PC9yZWxhdGVkLXVybHM+PC91cmxzPjwvcmVjb3JkPjwvQ2l0ZT48L0VuZE5vdGU+AAA=

ADDIN EN.CITE PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5aaXBlczwvQXV0aG9yPjxZZWFyPjIwMDY8L1llYXI+PFJl

Y051bT41NDI3PC9SZWNOdW0+PHJlY29yZD48cmVjLW51bWJlcj41NDI3PC9yZWMtbnVtYmVyPjxm

b3JlaWduLWtleXM+PGtleSBhcHA9IkVOIiBkYi1pZD0iZnIwdHpwcDJ2OXh0cG9ld2E1MnAwZXZx

c3oyZHZ2c3Q5c2QwIj41NDI3PC9rZXk+PC9mb3JlaWduLWtleXM+PHJlZi10eXBlIG5hbWU9Ikpv

dXJuYWwgQXJ0aWNsZSI+MTc8L3JlZi10eXBlPjxjb250cmlidXRvcnM+PGF1dGhvcnM+PGF1dGhv

cj5aaXBlcywgRC4gUC48L2F1dGhvcj48YXV0aG9yPkNhbW0sIEEuIEouPC9hdXRob3I+PGF1dGhv

cj5Cb3JnZ3JlZmUsIE0uPC9hdXRob3I+PGF1dGhvcj5CdXh0b24sIEEuIEUuPC9hdXRob3I+PGF1

dGhvcj5DaGFpdG1hbiwgQi48L2F1dGhvcj48YXV0aG9yPkZyb21lciwgTS48L2F1dGhvcj48YXV0

aG9yPkdyZWdvcmF0b3MsIEcuPC9hdXRob3I+PGF1dGhvcj5LbGVpbiwgRy48L2F1dGhvcj48YXV0

aG9yPk1vc3MsIEEuIEouPC9hdXRob3I+PGF1dGhvcj5NeWVyYnVyZywgUi4gSi48L2F1dGhvcj48

YXV0aG9yPlByaW9yaSwgUy4gRy48L2F1dGhvcj48YXV0aG9yPlF1aW5vbmVzLCBNLiBBLjwvYXV0

aG9yPjxhdXRob3I+Um9kZW4sIEQuIE0uPC9hdXRob3I+PGF1dGhvcj5TaWxrYSwgTS4gSi48L2F1

dGhvcj48YXV0aG9yPlRyYWN5LCBDLjwvYXV0aG9yPjxhdXRob3I+U21pdGgsIFMuIEMuLCBKci48

L2F1dGhvcj48YXV0aG9yPkphY29icywgQS4gSy48L2F1dGhvcj48YXV0aG9yPkFkYW1zLCBDLiBE

LjwvYXV0aG9yPjxhdXRob3I+QW50bWFuLCBFLiBNLjwvYXV0aG9yPjxhdXRob3I+QW5kZXJzb24s

IEouIEwuPC9hdXRob3I+PGF1dGhvcj5IdW50LCBTLiBBLjwvYXV0aG9yPjxhdXRob3I+SGFscGVy

aW4sIEouIEwuPC9hdXRob3I+PGF1dGhvcj5OaXNoaW11cmEsIFIuPC9hdXRob3I+PGF1dGhvcj5P

cm5hdG8sIEouIFAuPC9hdXRob3I+PGF1dGhvcj5QYWdlLCBSLiBMLjwvYXV0aG9yPjxhdXRob3I+

UmllZ2VsLCBCLjwvYXV0aG9yPjxhdXRob3I+QmxhbmMsIEouIEouPC9hdXRob3I+PGF1dGhvcj5C

dWRhaiwgQS48L2F1dGhvcj48YXV0aG9yPkRlYW4sIFYuPC9hdXRob3I+PGF1dGhvcj5EZWNrZXJz

LCBKLiBXLjwvYXV0aG9yPjxhdXRob3I+RGVzcHJlcywgQy48L2F1dGhvcj48YXV0aG9yPkRpY2tz

dGVpbiwgSy48L2F1dGhvcj48YXV0aG9yPkxla2FraXMsIEouPC9hdXRob3I+PGF1dGhvcj5NY0dy

ZWdvciwgSy48L2F1dGhvcj48YXV0aG9yPk1ldHJhLCBNLjwvYXV0aG9yPjxhdXRob3I+TW9yYWlz

LCBKLjwvYXV0aG9yPjxhdXRob3I+T3N0ZXJzcGV5LCBBLjwvYXV0aG9yPjxhdXRob3I+VGFtYXJn

bywgSi4gTC48L2F1dGhvcj48YXV0aG9yPlphbW9yYW5vLCBKLiBMLjwvYXV0aG9yPjwvYXV0aG9y

cz48L2NvbnRyaWJ1dG9ycz48dGl0bGVzPjx0aXRsZT5BQ0MvQUhBL0VTQyAyMDA2IEd1aWRlbGlu

ZXMgZm9yIE1hbmFnZW1lbnQgb2YgUGF0aWVudHMgV2l0aCBWZW50cmljdWxhciBBcnJoeXRobWlh

cyBhbmQgdGhlIFByZXZlbnRpb24gb2YgU3VkZGVuIENhcmRpYWMgRGVhdGg6IGEgcmVwb3J0IG9m

IHRoZSBBbWVyaWNhbiBDb2xsZWdlIG9mIENhcmRpb2xvZ3kvQW1lcmljYW4gSGVhcnQgQXNzb2Np

YXRpb24gVGFzayBGb3JjZSBhbmQgdGhlIEV1cm9wZWFuIFNvY2lldHkgb2YgQ2FyZGlvbG9neSBD

b21taXR0ZWUgZm9yIFByYWN0aWNlIEd1aWRlbGluZXMgKHdyaXRpbmcgY29tbWl0dGVlIHRvIGRl

dmVsb3AgR3VpZGVsaW5lcyBmb3IgTWFuYWdlbWVudCBvZiBQYXRpZW50cyBXaXRoIFZlbnRyaWN1

bGFyIEFycmh5dGhtaWFzIGFuZCB0aGUgUHJldmVudGlvbiBvZiBTdWRkZW4gQ2FyZGlhYyBEZWF0

aCk6IGRldmVsb3BlZCBpbiBjb2xsYWJvcmF0aW9uIHdpdGggdGhlIEV1cm9wZWFuIEhlYXJ0IFJo

eXRobSBBc3NvY2lhdGlvbiBhbmQgdGhlIEhlYXJ0IFJoeXRobSBTb2NpZXR5PC90aXRsZT48c2Vj

b25kYXJ5LXRpdGxlPkNpcmN1bGF0aW9uPC9zZWNvbmRhcnktdGl0bGU+PC90aXRsZXM+PHBlcmlv

ZGljYWw+PGZ1bGwtdGl0bGU+Q2lyY3VsYXRpb248L2Z1bGwtdGl0bGU+PC9wZXJpb2RpY2FsPjxw

YWdlcz5lMzg1LTQ4NDwvcGFnZXM+PHZvbHVtZT4xMTQ8L3ZvbHVtZT48bnVtYmVyPjEwPC9udW1i

ZXI+PGtleXdvcmRzPjxrZXl3b3JkPkFtZXJpY2FuIEhlYXJ0IEFzc29jaWF0aW9uPC9rZXl3b3Jk

PjxrZXl3b3JkPkFycmh5dGhtaWEvKnRoZXJhcHk8L2tleXdvcmQ+PGtleXdvcmQ+RGVhdGgsIFN1

ZGRlbiwgQ2FyZGlhYy8qcHJldmVudGlvbiAmYW1wOyBjb250cm9sPC9rZXl3b3JkPjxrZXl3b3Jk

PkV1cm9wZTwva2V5d29yZD48a2V5d29yZD5IdW1hbnM8L2tleXdvcmQ+PGtleXdvcmQ+UXVhbGl0

eSBBc3N1cmFuY2UsIEhlYWx0aCBDYXJlPC9rZXl3b3JkPjxrZXl3b3JkPlNvY2lldGllcywgTWVk

aWNhbDwva2V5d29yZD48a2V5d29yZD5WZW50cmljdWxhciBEeXNmdW5jdGlvbi8qdGhlcmFweTwv

a2V5d29yZD48L2tleXdvcmRzPjxkYXRlcz48eWVhcj4yMDA2PC95ZWFyPjwvZGF0ZXM+PGFjY2Vz

c2lvbi1udW0+MTY5MzU5OTU8L2FjY2Vzc2lvbi1udW0+PHVybHM+PHJlbGF0ZWQtdXJscz48dXJs

Pmh0dHA6Ly93d3cubmNiaS5ubG0ubmloLmdvdi9lbnRyZXovcXVlcnkuZmNnaT9jbWQ9UmV0cmll

dmUmYW1wO2RiPVB1Yk1lZCZhbXA7ZG9wdD1DaXRhdGlvbiZhbXA7bGlzdF91aWRzPTE2OTM1OTk1

PC91cmw+PC9yZWxhdGVkLXVybHM+PC91cmxzPjwvcmVjb3JkPjwvQ2l0ZT48L0VuZE5vdGU+AAA=

ADDIN EN.CITE.DATA 25.The use of an ICD to treat patients with a LQTS who have survived cardiac arrest is a class I indication according to AHA/ACC/ESC and of course, NICE guidelinesPEVuZE5vdGU+PENpdGU+PEF1dGhvcj5aaXBlczwvQXV0aG9yPjxZZWFyPjIwMDY8L1llYXI+PFJl

Y051bT41NDI3PC9SZWNOdW0+PHJlY29yZD48cmVjLW51bWJlcj41NDI3PC9yZWMtbnVtYmVyPjxm

b3JlaWduLWtleXM+PGtleSBhcHA9IkVOIiBkYi1pZD0iZnIwdHpwcDJ2OXh0cG9ld2E1MnAwZXZx

c3oyZHZ2c3Q5c2QwIj41NDI3PC9rZXk+PC9mb3JlaWduLWtleXM+PHJlZi10eXBlIG5hbWU9Ikpv

dXJuYWwgQXJ0aWNsZSI+MTc8L3JlZi10eXBlPjxjb250cmlidXRvcnM+PGF1dGhvcnM+PGF1dGhv

cj5aaXBlcywgRC4gUC48L2F1dGhvcj48YXV0aG9yPkNhbW0sIEEuIEouPC9hdXRob3I+PGF1dGhv

cj5Cb3JnZ3JlZmUsIE0uPC9hdXRob3I+PGF1dGhvcj5CdXh0b24sIEEuIEUuPC9hdXRob3I+PGF1

dGhvcj5DaGFpdG1hbiwgQi48L2F1dGhvcj48YXV0aG9yPkZyb21lciwgTS48L2F1dGhvcj48YXV0

aG9yPkdyZWdvcmF0b3MsIEcuPC9hdXRob3I+PGF1dGhvcj5LbGVpbiwgRy48L2F1dGhvcj48YXV0

aG9yPk1vc3MsIEEuIEouPC9hdXRob3I+PGF1dGhvcj5NeWVyYnVyZywgUi4gSi48L2F1dGhvcj48

YXV0aG9yPlByaW9yaSwgUy4gRy48L2F1dGhvcj48YXV0aG9yPlF1aW5vbmVzLCBNLiBBLjwvYXV0

aG9yPjxhdXRob3I+Um9kZW4sIEQuIE0uPC9hdXRob3I+PGF1dGhvcj5TaWxrYSwgTS4gSi48L2F1

dGhvcj48YXV0aG9yPlRyYWN5LCBDLjwvYXV0aG9yPjxhdXRob3I+U21pdGgsIFMuIEMuLCBKci48

L2F1dGhvcj48YXV0aG9yPkphY29icywgQS4gSy48L2F1dGhvcj48YXV0aG9yPkFkYW1zLCBDLiBE

LjwvYXV0aG9yPjxhdXRob3I+QW50bWFuLCBFLiBNLjwvYXV0aG9yPjxhdXRob3I+QW5kZXJzb24s

IEouIEwuPC9hdXRob3I+PGF1dGhvcj5IdW50LCBTLiBBLjwvYXV0aG9yPjxhdXRob3I+SGFscGVy

aW4sIEouIEwuPC9hdXRob3I+PGF1dGhvcj5OaXNoaW11cmEsIFIuPC9hdXRob3I+PGF1dGhvcj5P

cm5hdG8sIEouIFAuPC9hdXRob3I+PGF1dGhvcj5QYWdlLCBSLiBMLjwvYXV0aG9yPjxhdXRob3I+

UmllZ2VsLCBCLjwvYXV0aG9yPjxhdXRob3I+QmxhbmMsIEouIEouPC9hdXRob3I+PGF1dGhvcj5C

dWRhaiwgQS48L2F1dGhvcj48YXV0aG9yPkRlYW4sIFYuPC9hdXRob3I+PGF1dGhvcj5EZWNrZXJz

LCBKLiBXLjwvYXV0aG9yPjxhdXRob3I+RGVzcHJlcywgQy48L2F1dGhvcj48YXV0aG9yPkRpY2tz

dGVpbiwgSy48L2F1dGhvcj48YXV0aG9yPkxla2FraXMsIEouPC9hdXRob3I+PGF1dGhvcj5NY0dy

ZWdvciwgSy48L2F1dGhvcj48YXV0aG9yPk1ldHJhLCBNLjwvYXV0aG9yPjxhdXRob3I+TW9yYWlz

LCBKLjwvYXV0aG9yPjxhdXRob3I+T3N0ZXJzcGV5LCBBLjwvYXV0aG9yPjxhdXRob3I+VGFtYXJn

bywgSi4gTC48L2F1dGhvcj48YXV0aG9yPlphbW9yYW5vLCBKLiBMLjwvYXV0aG9yPjwvYXV0aG9y

cz48L2NvbnRyaWJ1dG9ycz48dGl0bGVzPjx0aXRsZT5BQ0MvQUhBL0VTQyAyMDA2IEd1aWRlbGlu

ZXMgZm9yIE1hbmFnZW1lbnQgb2YgUGF0aWVudHMgV2l0aCBWZW50cmljdWxhciBBcnJoeXRobWlh

cyBhbmQgdGhlIFByZXZlbnRpb24gb2YgU3VkZGVuIENhcmRpYWMgRGVhdGg6IGEgcmVwb3J0IG9m

IHRoZSBBbWVyaWNhbiBDb2xsZWdlIG9mIENhcmRpb2xvZ3kvQW1lcmljYW4gSGVhcnQgQXNzb2Np

YXRpb24gVGFzayBGb3JjZSBhbmQgdGhlIEV1cm9wZWFuIFNvY2lldHkgb2YgQ2FyZGlvbG9neSBD

b21taXR0ZWUgZm9yIFByYWN0aWNlIEd1aWRlbGluZXMgKHdyaXRpbmcgY29tbWl0dGVlIHRvIGRl

dmVsb3AgR3VpZGVsaW5lcyBmb3IgTWFuYWdlbWVudCBvZiBQYXRpZW50cyBXaXRoIFZlbnRyaWN1

bGFyIEFycmh5dGhtaWFzIGFuZCB0aGUgUHJldmVudGlvbiBvZiBTdWRkZW4gQ2FyZGlhYyBEZWF0

aCk6IGRldmVsb3BlZCBpbiBjb2xsYWJvcmF0aW9uIHdpdGggdGhlIEV1cm9wZWFuIEhlYXJ0IFJo

eXRobSBBc3NvY2lhdGlvbiBhbmQgdGhlIEhlYXJ0IFJoeXRobSBTb2NpZXR5PC90aXRsZT48c2Vj

b25kYXJ5LXRpdGxlPkNpcmN1bGF0aW9uPC9zZWNvbmRhcnktdGl0bGU+PC90aXRsZXM+PHBlcmlv

ZGljYWw+PGZ1bGwtdGl0bGU+Q2lyY3VsYXRpb248L2Z1bGwtdGl0bGU+PC9wZXJpb2RpY2FsPjxw

YWdlcz5lMzg1LTQ4NDwvcGFnZXM+PHZvbHVtZT4xMTQ8L3ZvbHVtZT48bnVtYmVyPjEwPC9udW1i

ZXI+PGtleXdvcmRzPjxrZXl3b3JkPkFtZXJpY2FuIEhlYXJ0IEFzc29jaWF0aW9uPC9rZXl3b3Jk

PjxrZXl3b3JkPkFycmh5dGhtaWEvKnRoZXJhcHk8L2tleXdvcmQ+PGtleXdvcmQ+RGVhdGgsIFN1

ZGRlbiwgQ2FyZGlhYy8qcHJldmVudGlvbiAmYW1wOyBjb250cm9sPC9rZXl3b3JkPjxrZXl3b3Jk

PkV1cm9wZTwva2V5d29yZD48a2V5d29yZD5IdW1hbnM8L2tleXdvcmQ+PGtleXdvcmQ+UXVhbGl0

eSBBc3N1cmFuY2UsIEhlYWx0aCBDYXJlPC9rZXl3b3JkPjxrZXl3b3JkPlNvY2lldGllcywgTWVk

aWNhbDwva2V5d29yZD48a2V5d29yZD5WZW50cmljdWxhciBEeXNmdW5jdGlvbi8qdGhlcmFweTwv

a2V5d29yZD48L2tleXdvcmRzPjxkYXRlcz48eWVhcj4yMDA2PC95ZWFyPjwvZGF0ZXM+PGFjY2Vz

c2lvbi1udW0+MTY5MzU5OTU8L2FjY2Vzc2lvbi1udW0+PHVybHM+PHJlbGF0ZWQtdXJscz48dXJs

Pmh0dHA6Ly93d3cubmNiaS5ubG0ubmloLmdvdi9lbnRyZXovcXVlcnkuZmNnaT9jbWQ9UmV0cmll

dmUmYW1wO2RiPVB1Yk1lZCZhbXA7ZG9wdD1DaXRhdGlvbiZhbXA7bGlzdF91aWRzPTE2OTM1OTk1

PC91cmw+PC9yZWxhdGVkLXVybHM+PC91cmxzPjwvcmVjb3JkPjwvQ2l0ZT48Q2l0ZT48WWVhcj4y

MDA2PC9ZZWFyPjxSZWNOdW0+NjgzOTwvUmVjTnVtPjxyZWNvcmQ+PHJlYy1udW1iZXI+NjgzOTwv

cmVjLW51bWJlcj48Zm9yZWlnbi1rZXlzPjxrZXkgYXBwPSJFTiIgZGItaWQ9ImZyMHR6cHAydjl4

dHBvZXdhNTJwMGV2cXN6MmR2dnN0OXNkMCI+NjgzOTwva2V5PjwvZm9yZWlnbi1rZXlzPjxyZWYt

dHlwZSBuYW1lPSJKb3VybmFsIEFydGljbGUiPjE3PC9yZWYtdHlwZT48Y29udHJpYnV0b3JzPjwv

Y29udHJpYnV0b3JzPjx0aXRsZXM+PHRpdGxlPkltcGxhbnRhYmxlIENhcmRpb3ZlcnRlciBEZWZp

YnJpbGxhdG9ycyBmb3IgQXJyaHl0aG1pYXMuIFRoZSBOYXRpb25hbCBJbnN0aXR1dGUgZm9yIEhl

YWx0aCBhbmQgQ2xpbmljYWwgRXhjZWxsZW5jZS48L3RpdGxlPjxzZWNvbmRhcnktdGl0bGU+VGVj

aG5vbG9neSBBcHByYWlzYWwgOTU8L3NlY29uZGFyeS10aXRsZT48L3RpdGxlcz48cGVyaW9kaWNh

bD48ZnVsbC10aXRsZT5UZWNobm9sb2d5IEFwcHJhaXNhbCA5NTwvZnVsbC10aXRsZT48L3Blcmlv

ZGljYWw+PGRhdGVzPjx5ZWFyPjIwMDY8L3llYXI+PC9kYXRlcz48dXJscz48L3VybHM+PC9yZWNv

cmQ+PC9DaXRlPjwvRW5kTm90ZT4AAAA=

ADDIN EN.CITE PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5aaXBlczwvQXV0aG9yPjxZZWFyPjIwMDY8L1llYXI+PFJl

Y051bT41NDI3PC9SZWNOdW0+PHJlY29yZD48cmVjLW51bWJlcj41NDI3PC9yZWMtbnVtYmVyPjxm

b3JlaWduLWtleXM+PGtleSBhcHA9IkVOIiBkYi1pZD0iZnIwdHpwcDJ2OXh0cG9ld2E1MnAwZXZx

c3oyZHZ2c3Q5c2QwIj41NDI3PC9rZXk+PC9mb3JlaWduLWtleXM+PHJlZi10eXBlIG5hbWU9Ikpv

dXJuYWwgQXJ0aWNsZSI+MTc8L3JlZi10eXBlPjxjb250cmlidXRvcnM+PGF1dGhvcnM+PGF1dGhv

cj5aaXBlcywgRC4gUC48L2F1dGhvcj48YXV0aG9yPkNhbW0sIEEuIEouPC9hdXRob3I+PGF1dGhv

cj5Cb3JnZ3JlZmUsIE0uPC9hdXRob3I+PGF1dGhvcj5CdXh0b24sIEEuIEUuPC9hdXRob3I+PGF1

dGhvcj5DaGFpdG1hbiwgQi48L2F1dGhvcj48YXV0aG9yPkZyb21lciwgTS48L2F1dGhvcj48YXV0

aG9yPkdyZWdvcmF0b3MsIEcuPC9hdXRob3I+PGF1dGhvcj5LbGVpbiwgRy48L2F1dGhvcj48YXV0

aG9yPk1vc3MsIEEuIEouPC9hdXRob3I+PGF1dGhvcj5NeWVyYnVyZywgUi4gSi48L2F1dGhvcj48

YXV0aG9yPlByaW9yaSwgUy4gRy48L2F1dGhvcj48YXV0aG9yPlF1aW5vbmVzLCBNLiBBLjwvYXV0

aG9yPjxhdXRob3I+Um9kZW4sIEQuIE0uPC9hdXRob3I+PGF1dGhvcj5TaWxrYSwgTS4gSi48L2F1

dGhvcj48YXV0aG9yPlRyYWN5LCBDLjwvYXV0aG9yPjxhdXRob3I+U21pdGgsIFMuIEMuLCBKci48

L2F1dGhvcj48YXV0aG9yPkphY29icywgQS4gSy48L2F1dGhvcj48YXV0aG9yPkFkYW1zLCBDLiBE

LjwvYXV0aG9yPjxhdXRob3I+QW50bWFuLCBFLiBNLjwvYXV0aG9yPjxhdXRob3I+QW5kZXJzb24s

IEouIEwuPC9hdXRob3I+PGF1dGhvcj5IdW50LCBTLiBBLjwvYXV0aG9yPjxhdXRob3I+SGFscGVy

aW4sIEouIEwuPC9hdXRob3I+PGF1dGhvcj5OaXNoaW11cmEsIFIuPC9hdXRob3I+PGF1dGhvcj5P

cm5hdG8sIEouIFAuPC9hdXRob3I+PGF1dGhvcj5QYWdlLCBSLiBMLjwvYXV0aG9yPjxhdXRob3I+

UmllZ2VsLCBCLjwvYXV0aG9yPjxhdXRob3I+QmxhbmMsIEouIEouPC9hdXRob3I+PGF1dGhvcj5C

dWRhaiwgQS48L2F1dGhvcj48YXV0aG9yPkRlYW4sIFYuPC9hdXRob3I+PGF1dGhvcj5EZWNrZXJz

LCBKLiBXLjwvYXV0aG9yPjxhdXRob3I+RGVzcHJlcywgQy48L2F1dGhvcj48YXV0aG9yPkRpY2tz

dGVpbiwgSy48L2F1dGhvcj48YXV0aG9yPkxla2FraXMsIEouPC9hdXRob3I+PGF1dGhvcj5NY0dy

ZWdvciwgSy48L2F1dGhvcj48YXV0aG9yPk1ldHJhLCBNLjwvYXV0aG9yPjxhdXRob3I+TW9yYWlz

LCBKLjwvYXV0aG9yPjxhdXRob3I+T3N0ZXJzcGV5LCBBLjwvYXV0aG9yPjxhdXRob3I+VGFtYXJn

bywgSi4gTC48L2F1dGhvcj48YXV0aG9yPlphbW9yYW5vLCBKLiBMLjwvYXV0aG9yPjwvYXV0aG9y

cz48L2NvbnRyaWJ1dG9ycz48dGl0bGVzPjx0aXRsZT5BQ0MvQUhBL0VTQyAyMDA2IEd1aWRlbGlu

ZXMgZm9yIE1hbmFnZW1lbnQgb2YgUGF0aWVudHMgV2l0aCBWZW50cmljdWxhciBBcnJoeXRobWlh

cyBhbmQgdGhlIFByZXZlbnRpb24gb2YgU3VkZGVuIENhcmRpYWMgRGVhdGg6IGEgcmVwb3J0IG9m

IHRoZSBBbWVyaWNhbiBDb2xsZWdlIG9mIENhcmRpb2xvZ3kvQW1lcmljYW4gSGVhcnQgQXNzb2Np

YXRpb24gVGFzayBGb3JjZSBhbmQgdGhlIEV1cm9wZWFuIFNvY2lldHkgb2YgQ2FyZGlvbG9neSBD

b21taXR0ZWUgZm9yIFByYWN0aWNlIEd1aWRlbGluZXMgKHdyaXRpbmcgY29tbWl0dGVlIHRvIGRl

dmVsb3AgR3VpZGVsaW5lcyBmb3IgTWFuYWdlbWVudCBvZiBQYXRpZW50cyBXaXRoIFZlbnRyaWN1

bGFyIEFycmh5dGhtaWFzIGFuZCB0aGUgUHJldmVudGlvbiBvZiBTdWRkZW4gQ2FyZGlhYyBEZWF0

aCk6IGRldmVsb3BlZCBpbiBjb2xsYWJvcmF0aW9uIHdpdGggdGhlIEV1cm9wZWFuIEhlYXJ0IFJo

eXRobSBBc3NvY2lhdGlvbiBhbmQgdGhlIEhlYXJ0IFJoeXRobSBTb2NpZXR5PC90aXRsZT48c2Vj

b25kYXJ5LXRpdGxlPkNpcmN1bGF0aW9uPC9zZWNvbmRhcnktdGl0bGU+PC90aXRsZXM+PHBlcmlv

ZGljYWw+PGZ1bGwtdGl0bGU+Q2lyY3VsYXRpb248L2Z1bGwtdGl0bGU+PC9wZXJpb2RpY2FsPjxw

YWdlcz5lMzg1LTQ4NDwvcGFnZXM+PHZvbHVtZT4xMTQ8L3ZvbHVtZT48bnVtYmVyPjEwPC9udW1i

ZXI+PGtleXdvcmRzPjxrZXl3b3JkPkFtZXJpY2FuIEhlYXJ0IEFzc29jaWF0aW9uPC9rZXl3b3Jk

PjxrZXl3b3JkPkFycmh5dGhtaWEvKnRoZXJhcHk8L2tleXdvcmQ+PGtleXdvcmQ+RGVhdGgsIFN1

ZGRlbiwgQ2FyZGlhYy8qcHJldmVudGlvbiAmYW1wOyBjb250cm9sPC9rZXl3b3JkPjxrZXl3b3Jk

PkV1cm9wZTwva2V5d29yZD48a2V5d29yZD5IdW1hbnM8L2tleXdvcmQ+PGtleXdvcmQ+UXVhbGl0

eSBBc3N1cmFuY2UsIEhlYWx0aCBDYXJlPC9rZXl3b3JkPjxrZXl3b3JkPlNvY2lldGllcywgTWVk

aWNhbDwva2V5d29yZD48a2V5d29yZD5WZW50cmljdWxhciBEeXNmdW5jdGlvbi8qdGhlcmFweTwv

a2V5d29yZD48L2tleXdvcmRzPjxkYXRlcz48eWVhcj4yMDA2PC95ZWFyPjwvZGF0ZXM+PGFjY2Vz

c2lvbi1udW0+MTY5MzU5OTU8L2FjY2Vzc2lvbi1udW0+PHVybHM+PHJlbGF0ZWQtdXJscz48dXJs

Pmh0dHA6Ly93d3cubmNiaS5ubG0ubmloLmdvdi9lbnRyZXovcXVlcnkuZmNnaT9jbWQ9UmV0cmll

dmUmYW1wO2RiPVB1Yk1lZCZhbXA7ZG9wdD1DaXRhdGlvbiZhbXA7bGlzdF91aWRzPTE2OTM1OTk1

PC91cmw+PC9yZWxhdGVkLXVybHM+PC91cmxzPjwvcmVjb3JkPjwvQ2l0ZT48Q2l0ZT48WWVhcj4y

MDA2PC9ZZWFyPjxSZWNOdW0+NjgzOTwvUmVjTnVtPjxyZWNvcmQ+PHJlYy1udW1iZXI+NjgzOTwv

cmVjLW51bWJlcj48Zm9yZWlnbi1rZXlzPjxrZXkgYXBwPSJFTiIgZGItaWQ9ImZyMHR6cHAydjl4

dHBvZXdhNTJwMGV2cXN6MmR2dnN0OXNkMCI+NjgzOTwva2V5PjwvZm9yZWlnbi1rZXlzPjxyZWYt

dHlwZSBuYW1lPSJKb3VybmFsIEFydGljbGUiPjE3PC9yZWYtdHlwZT48Y29udHJpYnV0b3JzPjwv

Y29udHJpYnV0b3JzPjx0aXRsZXM+PHRpdGxlPkltcGxhbnRhYmxlIENhcmRpb3ZlcnRlciBEZWZp

YnJpbGxhdG9ycyBmb3IgQXJyaHl0aG1pYXMuIFRoZSBOYXRpb25hbCBJbnN0aXR1dGUgZm9yIEhl

YWx0aCBhbmQgQ2xpbmljYWwgRXhjZWxsZW5jZS48L3RpdGxlPjxzZWNvbmRhcnktdGl0bGU+VGVj

aG5vbG9neSBBcHByYWlzYWwgOTU8L3NlY29uZGFyeS10aXRsZT48L3RpdGxlcz48cGVyaW9kaWNh

bD48ZnVsbC10aXRsZT5UZWNobm9sb2d5IEFwcHJhaXNhbCA5NTwvZnVsbC10aXRsZT48L3Blcmlv

ZGljYWw+PGRhdGVzPjx5ZWFyPjIwMDY8L3llYXI+PC9kYXRlcz48dXJscz48L3VybHM+PC9yZWNv

cmQ+PC9DaXRlPjwvRW5kTm90ZT4AAAA=

ADDIN EN.CITE.DATA 25, 34. The ESC/AHA guidelines include a long and detailed section on the management of LQTS, part of which is reproduced here; The NICE guidelines do not.An ICD may be indicated for some patients with LQTS for primary prevention. The indications are not clearly defined and the decision must be individualised and will depend in part on the clinical presentation, the genotype and the fears and beliefs of the patient. Family history does not necessarily have any bearing on riskPEVuZE5vdGU+PENpdGU+PEF1dGhvcj5Nb3NzPC9BdXRob3I+PFllYXI+MjAwMDwvWWVhcj48UmVj

TnVtPjM2Mzk8L1JlY051bT48cmVjb3JkPjxyZWMtbnVtYmVyPjM2Mzk8L3JlYy1udW1iZXI+PGZv

cmVpZ24ta2V5cz48a2V5IGFwcD0iRU4iIGRiLWlkPSJmcjB0enBwMnY5eHRwb2V3YTUycDBldnFz

ejJkdnZzdDlzZDAiPjM2Mzk8L2tleT48L2ZvcmVpZ24ta2V5cz48cmVmLXR5cGUgbmFtZT0iSm91

cm5hbCBBcnRpY2xlIj4xNzwvcmVmLXR5cGU+PGNvbnRyaWJ1dG9ycz48YXV0aG9ycz48YXV0aG9y

Pk1vc3MsIEEuIEouPC9hdXRob3I+PGF1dGhvcj5aYXJlYmEsIFcuPC9hdXRob3I+PGF1dGhvcj5I

YWxsLCBXLiBKLjwvYXV0aG9yPjxhdXRob3I+U2Nod2FydHosIFAuIEouPC9hdXRob3I+PGF1dGhv

cj5DcmFtcHRvbiwgUi4gUy48L2F1dGhvcj48YXV0aG9yPkJlbmhvcmluLCBKLjwvYXV0aG9yPjxh

dXRob3I+VmluY2VudCwgRy4gTS48L2F1dGhvcj48YXV0aG9yPkxvY2F0aSwgRS4gSC48L2F1dGhv

cj48YXV0aG9yPlByaW9yaSwgUy4gRy48L2F1dGhvcj48YXV0aG9yPk5hcG9saXRhbm8sIEMuPC9h

dXRob3I+PGF1dGhvcj5NZWRpbmEsIEEuPC9hdXRob3I+PGF1dGhvcj5aaGFuZywgTC48L2F1dGhv

cj48YXV0aG9yPlJvYmluc29uLCBKLiBMLjwvYXV0aG9yPjxhdXRob3I+VGltb3RoeSwgSy48L2F1

dGhvcj48YXV0aG9yPlRvd2JpbiwgSi4gQS48L2F1dGhvcj48YXV0aG9yPkFuZHJld3MsIE0uIEwu

PC9hdXRob3I+PC9hdXRob3JzPjwvY29udHJpYnV0b3JzPjxhdXRoLWFkZHJlc3M+RGVwYXJ0bWVu

dCBvZiBNZWRpY2luZSwgVW5pdmVyc2l0eSBvZiBSb2NoZXN0ZXIgU2Nob29sIG9mIE1lZGljaW5l

IGFuZCBEZW50aXN0cnksIE5ZIDE0NjQyLCBVU0EuIGhlYXJ0YWptQGhlYXJ0LnJvY2hlc3Rlci5l

ZHU8L2F1dGgtYWRkcmVzcz48dGl0bGVzPjx0aXRsZT5FZmZlY3RpdmVuZXNzIGFuZCBsaW1pdGF0

aW9ucyBvZiBiZXRhLWJsb2NrZXIgdGhlcmFweSBpbiBjb25nZW5pdGFsIGxvbmctUVQgc3luZHJv

bWU8L3RpdGxlPjxzZWNvbmRhcnktdGl0bGU+Q2lyY3VsYXRpb248L3NlY29uZGFyeS10aXRsZT48

L3RpdGxlcz48cGVyaW9kaWNhbD48ZnVsbC10aXRsZT5DaXJjdWxhdGlvbjwvZnVsbC10aXRsZT48

L3BlcmlvZGljYWw+PHBhZ2VzPjYxNi0yMzwvcGFnZXM+PHZvbHVtZT4xMDE8L3ZvbHVtZT48bnVt

YmVyPjY8L251bWJlcj48ZWRpdGlvbj4yMDAwLzAyLzE1PC9lZGl0aW9uPjxrZXl3b3Jkcz48a2V5

d29yZD5BZG9sZXNjZW50PC9rZXl3b3JkPjxrZXl3b3JkPkFkcmVuZXJnaWMgYmV0YS1BbnRhZ29u

aXN0cy8qYWRtaW5pc3RyYXRpb24gJmFtcDsgZG9zYWdlL2FkdmVyc2UgZWZmZWN0czwva2V5d29y

ZD48a2V5d29yZD5BZHVsdDwva2V5d29yZD48a2V5d29yZD5BdGVub2xvbC9hZG1pbmlzdHJhdGlv

biAmYW1wOyBkb3NhZ2UvYWR2ZXJzZSBlZmZlY3RzPC9rZXl3b3JkPjxrZXl3b3JkPkNoaWxkPC9r

ZXl3b3JkPjxrZXl3b3JkPkNoaWxkLCBQcmVzY2hvb2w8L2tleXdvcmQ+PGtleXdvcmQ+RmVtYWxl

PC9rZXl3b3JkPjxrZXl3b3JkPkh1bWFuczwva2V5d29yZD48a2V5d29yZD5JbmZhbnQ8L2tleXdv

cmQ+PGtleXdvcmQ+TG9uZyBRVCBTeW5kcm9tZS9jb25nZW5pdGFsLypkcnVnIHRoZXJhcHkvcGh5

c2lvcGF0aG9sb2d5PC9rZXl3b3JkPjxrZXl3b3JkPk1hbGU8L2tleXdvcmQ+PGtleXdvcmQ+TWV0

b3Byb2xvbC9hZG1pbmlzdHJhdGlvbiAmYW1wOyBkb3NhZ2UvYWR2ZXJzZSBlZmZlY3RzPC9rZXl3

b3JkPjxrZXl3b3JkPk5hZG9sb2wvYWRtaW5pc3RyYXRpb24gJmFtcDsgZG9zYWdlL2FkdmVyc2Ug

ZWZmZWN0czwva2V5d29yZD48a2V5d29yZD5Qcm9wcmFub2xvbC9hZG1pbmlzdHJhdGlvbiAmYW1w

OyBkb3NhZ2UvYWR2ZXJzZSBlZmZlY3RzPC9rZXl3b3JkPjxrZXl3b3JkPlN1cnZpdmFsIEFuYWx5

c2lzPC9rZXl3b3JkPjwva2V5d29yZHM+PGRhdGVzPjx5ZWFyPjIwMDA8L3llYXI+PHB1Yi1kYXRl

cz48ZGF0ZT5GZWIgMTU8L2RhdGU+PC9wdWItZGF0ZXM+PC9kYXRlcz48aXNibj4xNTI0LTQ1Mzkg

KEVsZWN0cm9uaWMpPC9pc2JuPjxhY2Nlc3Npb24tbnVtPjEwNjczMjUzPC9hY2Nlc3Npb24tbnVt

Pjx1cmxzPjxyZWxhdGVkLXVybHM+PHVybD5odHRwOi8vd3d3Lm5jYmkubmxtLm5paC5nb3YvZW50

cmV6L3F1ZXJ5LmZjZ2k/Y21kPVJldHJpZXZlJmFtcDtkYj1QdWJNZWQmYW1wO2RvcHQ9Q2l0YXRp

b24mYW1wO2xpc3RfdWlkcz0xMDY3MzI1MzwvdXJsPjwvcmVsYXRlZC11cmxzPjwvdXJscz48bGFu

Z3VhZ2U+ZW5nPC9sYW5ndWFnZT48L3JlY29yZD48L0NpdGU+PENpdGU+PEF1dGhvcj5Dcm90dGk8

L0F1dGhvcj48WWVhcj4yMDA1PC9ZZWFyPjxSZWNOdW0+MTc1MDwvUmVjTnVtPjxyZWNvcmQ+PHJl

Yy1udW1iZXI+MTc1MDwvcmVjLW51bWJlcj48Zm9yZWlnbi1rZXlzPjxrZXkgYXBwPSJFTiIgZGIt

aWQ9ImZyMHR6cHAydjl4dHBvZXdhNTJwMGV2cXN6MmR2dnN0OXNkMCI+MTc1MDwva2V5PjwvZm9y

ZWlnbi1rZXlzPjxyZWYtdHlwZSBuYW1lPSJKb3VybmFsIEFydGljbGUiPjE3PC9yZWYtdHlwZT48

Y29udHJpYnV0b3JzPjxhdXRob3JzPjxhdXRob3I+Q3JvdHRpLCBMLjwvYXV0aG9yPjxhdXRob3I+

THVuZHF1aXN0LCBBLiBMLjwvYXV0aG9yPjxhdXRob3I+SW5zb2xpYSwgUi48L2F1dGhvcj48YXV0

aG9yPlBlZHJhenppbmksIE0uPC9hdXRob3I+PGF1dGhvcj5GZXJyYW5kaSwgQy48L2F1dGhvcj48

YXV0aG9yPkRlIEZlcnJhcmksIEcuIE0uPC9hdXRob3I+PGF1dGhvcj5WaWNlbnRpbmksIEEuPC9h

dXRob3I+PGF1dGhvcj5ZYW5nLCBQLjwvYXV0aG9yPjxhdXRob3I+Um9kZW4sIEQuIE0uPC9hdXRo

b3I+PGF1dGhvcj5HZW9yZ2UsIEEuIEwuLCBKci48L2F1dGhvcj48YXV0aG9yPlNjaHdhcnR6LCBQ

LiBKLjwvYXV0aG9yPjwvYXV0aG9ycz48L2NvbnRyaWJ1dG9ycz48YXV0aC1hZGRyZXNzPkRlcGFy

dG1lbnQgb2YgQ2FyZGlvbG9neSwgVW5pdmVyc2l0eSBvZiBQYXZpYSwgSVJDQ1MgUG9saWNsaW5p

Y28gUy4gTWF0dGVvLCBQYXZpYSwgSXRhbHkuPC9hdXRoLWFkZHJlc3M+PHRpdGxlcz48dGl0bGU+

S0NOSDItSzg5N1QgaXMgYSBnZW5ldGljIG1vZGlmaWVyIG9mIGxhdGVudCBjb25nZW5pdGFsIGxv

bmctUVQgc3luZHJvbWU8L3RpdGxlPjxzZWNvbmRhcnktdGl0bGU+Q2lyY3VsYXRpb248L3NlY29u

ZGFyeS10aXRsZT48L3RpdGxlcz48cGVyaW9kaWNhbD48ZnVsbC10aXRsZT5DaXJjdWxhdGlvbjwv

ZnVsbC10aXRsZT48L3BlcmlvZGljYWw+PHBhZ2VzPjEyNTEtODwvcGFnZXM+PHZvbHVtZT4xMTI8

L3ZvbHVtZT48bnVtYmVyPjk8L251bWJlcj48ZWRpdGlvbj4yMDA1LzA4LzI0PC9lZGl0aW9uPjxr

ZXl3b3Jkcz48a2V5d29yZD5BZHVsdDwva2V5d29yZD48a2V5d29yZD5EZWF0aCwgU3VkZGVuLCBD

YXJkaWFjL2V0aW9sb2d5PC9rZXl3b3JkPjxrZXl3b3JkPkVsZWN0cm9jYXJkaW9ncmFwaHk8L2tl

eXdvcmQ+PGtleXdvcmQ+RXRoZXItQS1Hby1HbyBQb3Rhc3NpdW0gQ2hhbm5lbHMvKmdlbmV0aWNz

PC9rZXl3b3JkPjxrZXl3b3JkPkZlbWFsZTwva2V5d29yZD48a2V5d29yZD5IdW1hbnM8L2tleXdv

cmQ+PGtleXdvcmQ+TG9uZyBRVCBTeW5kcm9tZS8qZ2VuZXRpY3MvcGh5c2lvcGF0aG9sb2d5PC9r

ZXl3b3JkPjxrZXl3b3JkPipNdXRhdGlvbjwva2V5d29yZD48a2V5d29yZD5QaGVub3R5cGU8L2tl

eXdvcmQ+PGtleXdvcmQ+KlBvbHltb3JwaGlzbSwgU2luZ2xlIE51Y2xlb3RpZGU8L2tleXdvcmQ+

PC9rZXl3b3Jkcz48ZGF0ZXM+PHllYXI+MjAwNTwveWVhcj48cHViLWRhdGVzPjxkYXRlPkF1ZyAz

MDwvZGF0ZT48L3B1Yi1kYXRlcz48L2RhdGVzPjxpc2JuPjE1MjQtNDUzOSAoRWxlY3Ryb25pYyk8

L2lzYm4+PGFjY2Vzc2lvbi1udW0+MTYxMTYwNTI8L2FjY2Vzc2lvbi1udW0+PHVybHM+PHJlbGF0

ZWQtdXJscz48dXJsPmh0dHA6Ly93d3cubmNiaS5ubG0ubmloLmdvdi9lbnRyZXovcXVlcnkuZmNn

aT9jbWQ9UmV0cmlldmUmYW1wO2RiPVB1Yk1lZCZhbXA7ZG9wdD1DaXRhdGlvbiZhbXA7bGlzdF91

aWRzPTE2MTE2MDUyPC91cmw+PC9yZWxhdGVkLXVybHM+PC91cmxzPjxlbGVjdHJvbmljLXJlc291

cmNlLW51bT5DSVJDVUxBVElPTkFIQS4xMDUuNTQ5MDcxIFtwaWldJiN4RDsxMC4xMTYxL0NJUkNV

TEFUSU9OQUhBLjEwNS41NDkwNzE8L2VsZWN0cm9uaWMtcmVzb3VyY2UtbnVtPjxsYW5ndWFnZT5l

bmc8L2xhbmd1YWdlPjwvcmVjb3JkPjwvQ2l0ZT48L0VuZE5vdGU+AAAA

ADDIN EN.CITE PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5Nb3NzPC9BdXRob3I+PFllYXI+MjAwMDwvWWVhcj48UmVj

TnVtPjM2Mzk8L1JlY051bT48cmVjb3JkPjxyZWMtbnVtYmVyPjM2Mzk8L3JlYy1udW1iZXI+PGZv

cmVpZ24ta2V5cz48a2V5IGFwcD0iRU4iIGRiLWlkPSJmcjB0enBwMnY5eHRwb2V3YTUycDBldnFz

ejJkdnZzdDlzZDAiPjM2Mzk8L2tleT48L2ZvcmVpZ24ta2V5cz48cmVmLXR5cGUgbmFtZT0iSm91

cm5hbCBBcnRpY2xlIj4xNzwvcmVmLXR5cGU+PGNvbnRyaWJ1dG9ycz48YXV0aG9ycz48YXV0aG9y

Pk1vc3MsIEEuIEouPC9hdXRob3I+PGF1dGhvcj5aYXJlYmEsIFcuPC9hdXRob3I+PGF1dGhvcj5I

YWxsLCBXLiBKLjwvYXV0aG9yPjxhdXRob3I+U2Nod2FydHosIFAuIEouPC9hdXRob3I+PGF1dGhv

cj5DcmFtcHRvbiwgUi4gUy48L2F1dGhvcj48YXV0aG9yPkJlbmhvcmluLCBKLjwvYXV0aG9yPjxh

dXRob3I+VmluY2VudCwgRy4gTS48L2F1dGhvcj48YXV0aG9yPkxvY2F0aSwgRS4gSC48L2F1dGhv

cj48YXV0aG9yPlByaW9yaSwgUy4gRy48L2F1dGhvcj48YXV0aG9yPk5hcG9saXRhbm8sIEMuPC9h

dXRob3I+PGF1dGhvcj5NZWRpbmEsIEEuPC9hdXRob3I+PGF1dGhvcj5aaGFuZywgTC48L2F1dGhv

cj48YXV0aG9yPlJvYmluc29uLCBKLiBMLjwvYXV0aG9yPjxhdXRob3I+VGltb3RoeSwgSy48L2F1

dGhvcj48YXV0aG9yPlRvd2JpbiwgSi4gQS48L2F1dGhvcj48YXV0aG9yPkFuZHJld3MsIE0uIEwu

PC9hdXRob3I+PC9hdXRob3JzPjwvY29udHJpYnV0b3JzPjxhdXRoLWFkZHJlc3M+RGVwYXJ0bWVu

dCBvZiBNZWRpY2luZSwgVW5pdmVyc2l0eSBvZiBSb2NoZXN0ZXIgU2Nob29sIG9mIE1lZGljaW5l

IGFuZCBEZW50aXN0cnksIE5ZIDE0NjQyLCBVU0EuIGhlYXJ0YWptQGhlYXJ0LnJvY2hlc3Rlci5l

ZHU8L2F1dGgtYWRkcmVzcz48dGl0bGVzPjx0aXRsZT5FZmZlY3RpdmVuZXNzIGFuZCBsaW1pdGF0

aW9ucyBvZiBiZXRhLWJsb2NrZXIgdGhlcmFweSBpbiBjb25nZW5pdGFsIGxvbmctUVQgc3luZHJv

bWU8L3RpdGxlPjxzZWNvbmRhcnktdGl0bGU+Q2lyY3VsYXRpb248L3NlY29uZGFyeS10aXRsZT48

L3RpdGxlcz48cGVyaW9kaWNhbD48ZnVsbC10aXRsZT5DaXJjdWxhdGlvbjwvZnVsbC10aXRsZT48

L3BlcmlvZGljYWw+PHBhZ2VzPjYxNi0yMzwvcGFnZXM+PHZvbHVtZT4xMDE8L3ZvbHVtZT48bnVt

YmVyPjY8L251bWJlcj48ZWRpdGlvbj4yMDAwLzAyLzE1PC9lZGl0aW9uPjxrZXl3b3Jkcz48a2V5

d29yZD5BZG9sZXNjZW50PC9rZXl3b3JkPjxrZXl3b3JkPkFkcmVuZXJnaWMgYmV0YS1BbnRhZ29u

aXN0cy8qYWRtaW5pc3RyYXRpb24gJmFtcDsgZG9zYWdlL2FkdmVyc2UgZWZmZWN0czwva2V5d29y

ZD48a2V5d29yZD5BZHVsdDwva2V5d29yZD48a2V5d29yZD5BdGVub2xvbC9hZG1pbmlzdHJhdGlv

biAmYW1wOyBkb3NhZ2UvYWR2ZXJzZSBlZmZlY3RzPC9rZXl3b3JkPjxrZXl3b3JkPkNoaWxkPC9r

ZXl3b3JkPjxrZXl3b3JkPkNoaWxkLCBQcmVzY2hvb2w8L2tleXdvcmQ+PGtleXdvcmQ+RmVtYWxl

PC9rZXl3b3JkPjxrZXl3b3JkPkh1bWFuczwva2V5d29yZD48a2V5d29yZD5JbmZhbnQ8L2tleXdv

cmQ+PGtleXdvcmQ+TG9uZyBRVCBTeW5kcm9tZS9jb25nZW5pdGFsLypkcnVnIHRoZXJhcHkvcGh5

c2lvcGF0aG9sb2d5PC9rZXl3b3JkPjxrZXl3b3JkPk1hbGU8L2tleXdvcmQ+PGtleXdvcmQ+TWV0

b3Byb2xvbC9hZG1pbmlzdHJhdGlvbiAmYW1wOyBkb3NhZ2UvYWR2ZXJzZSBlZmZlY3RzPC9rZXl3

b3JkPjxrZXl3b3JkPk5hZG9sb2wvYWRtaW5pc3RyYXRpb24gJmFtcDsgZG9zYWdlL2FkdmVyc2Ug

ZWZmZWN0czwva2V5d29yZD48a2V5d29yZD5Qcm9wcmFub2xvbC9hZG1pbmlzdHJhdGlvbiAmYW1w

OyBkb3NhZ2UvYWR2ZXJzZSBlZmZlY3RzPC9rZXl3b3JkPjxrZXl3b3JkPlN1cnZpdmFsIEFuYWx5

c2lzPC9rZXl3b3JkPjwva2V5d29yZHM+PGRhdGVzPjx5ZWFyPjIwMDA8L3llYXI+PHB1Yi1kYXRl

cz48ZGF0ZT5GZWIgMTU8L2RhdGU+PC9wdWItZGF0ZXM+PC9kYXRlcz48aXNibj4xNTI0LTQ1Mzkg

KEVsZWN0cm9uaWMpPC9pc2JuPjxhY2Nlc3Npb24tbnVtPjEwNjczMjUzPC9hY2Nlc3Npb24tbnVt

Pjx1cmxzPjxyZWxhdGVkLXVybHM+PHVybD5odHRwOi8vd3d3Lm5jYmkubmxtLm5paC5nb3YvZW50

cmV6L3F1ZXJ5LmZjZ2k/Y21kPVJldHJpZXZlJmFtcDtkYj1QdWJNZWQmYW1wO2RvcHQ9Q2l0YXRp

b24mYW1wO2xpc3RfdWlkcz0xMDY3MzI1MzwvdXJsPjwvcmVsYXRlZC11cmxzPjwvdXJscz48bGFu

Z3VhZ2U+ZW5nPC9sYW5ndWFnZT48L3JlY29yZD48L0NpdGU+PENpdGU+PEF1dGhvcj5Dcm90dGk8

L0F1dGhvcj48WWVhcj4yMDA1PC9ZZWFyPjxSZWNOdW0+MTc1MDwvUmVjTnVtPjxyZWNvcmQ+PHJl

Yy1udW1iZXI+MTc1MDwvcmVjLW51bWJlcj48Zm9yZWlnbi1rZXlzPjxrZXkgYXBwPSJFTiIgZGIt

aWQ9ImZyMHR6cHAydjl4dHBvZXdhNTJwMGV2cXN6MmR2dnN0OXNkMCI+MTc1MDwva2V5PjwvZm9y

ZWlnbi1rZXlzPjxyZWYtdHlwZSBuYW1lPSJKb3VybmFsIEFydGljbGUiPjE3PC9yZWYtdHlwZT48

Y29udHJpYnV0b3JzPjxhdXRob3JzPjxhdXRob3I+Q3JvdHRpLCBMLjwvYXV0aG9yPjxhdXRob3I+

THVuZHF1aXN0LCBBLiBMLjwvYXV0aG9yPjxhdXRob3I+SW5zb2xpYSwgUi48L2F1dGhvcj48YXV0

aG9yPlBlZHJhenppbmksIE0uPC9hdXRob3I+PGF1dGhvcj5GZXJyYW5kaSwgQy48L2F1dGhvcj48

YXV0aG9yPkRlIEZlcnJhcmksIEcuIE0uPC9hdXRob3I+PGF1dGhvcj5WaWNlbnRpbmksIEEuPC9h

dXRob3I+PGF1dGhvcj5ZYW5nLCBQLjwvYXV0aG9yPjxhdXRob3I+Um9kZW4sIEQuIE0uPC9hdXRo

b3I+PGF1dGhvcj5HZW9yZ2UsIEEuIEwuLCBKci48L2F1dGhvcj48YXV0aG9yPlNjaHdhcnR6LCBQ

LiBKLjwvYXV0aG9yPjwvYXV0aG9ycz48L2NvbnRyaWJ1dG9ycz48YXV0aC1hZGRyZXNzPkRlcGFy

dG1lbnQgb2YgQ2FyZGlvbG9neSwgVW5pdmVyc2l0eSBvZiBQYXZpYSwgSVJDQ1MgUG9saWNsaW5p

Y28gUy4gTWF0dGVvLCBQYXZpYSwgSXRhbHkuPC9hdXRoLWFkZHJlc3M+PHRpdGxlcz48dGl0bGU+

S0NOSDItSzg5N1QgaXMgYSBnZW5ldGljIG1vZGlmaWVyIG9mIGxhdGVudCBjb25nZW5pdGFsIGxv

bmctUVQgc3luZHJvbWU8L3RpdGxlPjxzZWNvbmRhcnktdGl0bGU+Q2lyY3VsYXRpb248L3NlY29u

ZGFyeS10aXRsZT48L3RpdGxlcz48cGVyaW9kaWNhbD48ZnVsbC10aXRsZT5DaXJjdWxhdGlvbjwv

ZnVsbC10aXRsZT48L3BlcmlvZGljYWw+PHBhZ2VzPjEyNTEtODwvcGFnZXM+PHZvbHVtZT4xMTI8

L3ZvbHVtZT48bnVtYmVyPjk8L251bWJlcj48ZWRpdGlvbj4yMDA1LzA4LzI0PC9lZGl0aW9uPjxr

ZXl3b3Jkcz48a2V5d29yZD5BZHVsdDwva2V5d29yZD48a2V5d29yZD5EZWF0aCwgU3VkZGVuLCBD

YXJkaWFjL2V0aW9sb2d5PC9rZXl3b3JkPjxrZXl3b3JkPkVsZWN0cm9jYXJkaW9ncmFwaHk8L2tl

eXdvcmQ+PGtleXdvcmQ+RXRoZXItQS1Hby1HbyBQb3Rhc3NpdW0gQ2hhbm5lbHMvKmdlbmV0aWNz

PC9rZXl3b3JkPjxrZXl3b3JkPkZlbWFsZTwva2V5d29yZD48a2V5d29yZD5IdW1hbnM8L2tleXdv

cmQ+PGtleXdvcmQ+TG9uZyBRVCBTeW5kcm9tZS8qZ2VuZXRpY3MvcGh5c2lvcGF0aG9sb2d5PC9r

ZXl3b3JkPjxrZXl3b3JkPipNdXRhdGlvbjwva2V5d29yZD48a2V5d29yZD5QaGVub3R5cGU8L2tl

eXdvcmQ+PGtleXdvcmQ+KlBvbHltb3JwaGlzbSwgU2luZ2xlIE51Y2xlb3RpZGU8L2tleXdvcmQ+

PC9rZXl3b3Jkcz48ZGF0ZXM+PHllYXI+MjAwNTwveWVhcj48cHViLWRhdGVzPjxkYXRlPkF1ZyAz

MDwvZGF0ZT48L3B1Yi1kYXRlcz48L2RhdGVzPjxpc2JuPjE1MjQtNDUzOSAoRWxlY3Ryb25pYyk8

L2lzYm4+PGFjY2Vzc2lvbi1udW0+MTYxMTYwNTI8L2FjY2Vzc2lvbi1udW0+PHVybHM+PHJlbGF0

ZWQtdXJscz48dXJsPmh0dHA6Ly93d3cubmNiaS5ubG0ubmloLmdvdi9lbnRyZXovcXVlcnkuZmNn

aT9jbWQ9UmV0cmlldmUmYW1wO2RiPVB1Yk1lZCZhbXA7ZG9wdD1DaXRhdGlvbiZhbXA7bGlzdF91

aWRzPTE2MTE2MDUyPC91cmw+PC9yZWxhdGVkLXVybHM+PC91cmxzPjxlbGVjdHJvbmljLXJlc291

cmNlLW51bT5DSVJDVUxBVElPTkFIQS4xMDUuNTQ5MDcxIFtwaWldJiN4RDsxMC4xMTYxL0NJUkNV

TEFUSU9OQUhBLjEwNS41NDkwNzE8L2VsZWN0cm9uaWMtcmVzb3VyY2UtbnVtPjxsYW5ndWFnZT5l

bmc8L2xhbmd1YWdlPjwvcmVjb3JkPjwvQ2l0ZT48L0VuZE5vdGU+AAAA

ADDIN EN.CITE.DATA 29, 35. A QTc ≥ 500ms and syncope or a history of aborted sudden cardiac death appear to be the best predictors of future events ADDIN EN.CITE <EndNote><Cite><Author>Nademanee</Author><Year>2009</Year><RecNum>5425</RecNum><record><rec-number>5425</rec-number><foreign-keys><key app="EN" db-id="fr0tzpp2v9xtpoewa52p0evqsz2dvvst9sd0">5425</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Nademanee, K.</author></authors></contributors><titles><title> Genotype-Phenotype Relationship in the Long QT Syndrome: Brimming with Knowledge but Thirsting for a Therapeutic Solution.</title><secondary-title>J Am Coll Cardiol</secondary-title></titles><periodical><full-title>J Am Coll Cardiol</full-title></periodical><pages>2063-4.</pages><volume>54</volume><dates><year>2009</year></dates><urls></urls></record></Cite></EndNote>33. The precise genetic mutation may be a predictor of risk and a number of studies have identified higher risk mutationsPEVuZE5vdGU+PENpdGU+PEF1dGhvcj5Nb3NzPC9BdXRob3I+PFllYXI+MjAwNzwvWWVhcj48UmVj

TnVtPjEwMjA8L1JlY051bT48cmVjb3JkPjxyZWMtbnVtYmVyPjEwMjA8L3JlYy1udW1iZXI+PGZv

cmVpZ24ta2V5cz48a2V5IGFwcD0iRU4iIGRiLWlkPSJmcjB0enBwMnY5eHRwb2V3YTUycDBldnFz

ejJkdnZzdDlzZDAiPjEwMjA8L2tleT48L2ZvcmVpZ24ta2V5cz48cmVmLXR5cGUgbmFtZT0iSm91

cm5hbCBBcnRpY2xlIj4xNzwvcmVmLXR5cGU+PGNvbnRyaWJ1dG9ycz48YXV0aG9ycz48YXV0aG9y

Pk1vc3MsIEEuIEouPC9hdXRob3I+PGF1dGhvcj5TaGltaXp1LCBXLjwvYXV0aG9yPjxhdXRob3I+

V2lsZGUsIEEuIEEuPC9hdXRob3I+PGF1dGhvcj5Ub3diaW4sIEouIEEuPC9hdXRob3I+PGF1dGhv

cj5aYXJlYmEsIFcuPC9hdXRob3I+PGF1dGhvcj5Sb2JpbnNvbiwgSi4gTC48L2F1dGhvcj48YXV0

aG9yPlFpLCBNLjwvYXV0aG9yPjxhdXRob3I+VmluY2VudCwgRy4gTS48L2F1dGhvcj48YXV0aG9y

PkFja2VybWFuLCBNLiBKLjwvYXV0aG9yPjxhdXRob3I+S2F1Zm1hbiwgRS4gUy48L2F1dGhvcj48

YXV0aG9yPkhvZm1hbiwgTi48L2F1dGhvcj48YXV0aG9yPlNldGgsIFIuPC9hdXRob3I+PGF1dGhv

cj5LYW1ha3VyYSwgUy48L2F1dGhvcj48YXV0aG9yPk1peWFtb3RvLCBZLjwvYXV0aG9yPjxhdXRo

b3I+R29sZGVuYmVyZywgSS48L2F1dGhvcj48YXV0aG9yPkFuZHJld3MsIE0uIEwuPC9hdXRob3I+

PGF1dGhvcj5NY05pdHQsIFMuPC9hdXRob3I+PC9hdXRob3JzPjwvY29udHJpYnV0b3JzPjxhdXRo

LWFkZHJlc3M+Q2FyZGlvbG9neSBEaXZpc2lvbiwgRGVwYXJ0bWVudCBvZiBNZWRpY2luZSwgVW5p

dmVyc2l0eSBvZiBSb2NoZXN0ZXIgU2Nob29sIG9mIE1lZGljaW5lIGFuZCBEZW50aXN0cnksIFJv

Y2hlc3RlciwgTlksIFVTQS4gaGVhcnRham1AaGVhcnQucm9jaGVzdGVyLmVkdTwvYXV0aC1hZGRy

ZXNzPjx0aXRsZXM+PHRpdGxlPkNsaW5pY2FsIGFzcGVjdHMgb2YgdHlwZS0xIGxvbmctUVQgc3lu

ZHJvbWUgYnkgbG9jYXRpb24sIGNvZGluZyB0eXBlLCBhbmQgYmlvcGh5c2ljYWwgZnVuY3Rpb24g

b2YgbXV0YXRpb25zIGludm9sdmluZyB0aGUgS0NOUTEgZ2VuZTwvdGl0bGU+PHNlY29uZGFyeS10

aXRsZT5DaXJjdWxhdGlvbjwvc2Vjb25kYXJ5LXRpdGxlPjwvdGl0bGVzPjxwZXJpb2RpY2FsPjxm

dWxsLXRpdGxlPkNpcmN1bGF0aW9uPC9mdWxsLXRpdGxlPjwvcGVyaW9kaWNhbD48cGFnZXM+MjQ4

MS05PC9wYWdlcz48dm9sdW1lPjExNTwvdm9sdW1lPjxudW1iZXI+MTk8L251bWJlcj48ZWRpdGlv

bj4yMDA3LzA1LzAyPC9lZGl0aW9uPjxrZXl3b3Jkcz48a2V5d29yZD5BZG9sZXNjZW50PC9rZXl3

b3JkPjxrZXl3b3JkPkFkcmVuZXJnaWMgYmV0YS1BbnRhZ29uaXN0cy90aGVyYXBldXRpYyB1c2U8

L2tleXdvcmQ+PGtleXdvcmQ+QWR1bHQ8L2tleXdvcmQ+PGtleXdvcmQ+Q2hpbGQ8L2tleXdvcmQ+

PGtleXdvcmQ+Q2hpbGQsIFByZXNjaG9vbDwva2V5d29yZD48a2V5d29yZD5Db2RvbiwgTm9uc2Vu

c2U8L2tleXdvcmQ+PGtleXdvcmQ+RGVhdGgsIFN1ZGRlbiwgQ2FyZGlhYy9lcGlkZW1pb2xvZ3kv

cHJldmVudGlvbiAmYW1wOyBjb250cm9sPC9rZXl3b3JkPjxrZXl3b3JkPkZlbWFsZTwva2V5d29y

ZD48a2V5d29yZD5GcmFtZXNoaWZ0IE11dGF0aW9uPC9rZXl3b3JkPjxrZXl3b3JkPkdlbmV0aWMg

UHJlZGlzcG9zaXRpb24gdG8gRGlzZWFzZTwva2V5d29yZD48a2V5d29yZD5HZW5vdHlwZTwva2V5

d29yZD48a2V5d29yZD5IZWFydCBBcnJlc3QvZXBpZGVtaW9sb2d5PC9rZXl3b3JkPjxrZXl3b3Jk

Pkh1bWFuczwva2V5d29yZD48a2V5d29yZD5JbmZhbnQ8L2tleXdvcmQ+PGtleXdvcmQ+SW5mYW50

LCBOZXdib3JuPC9rZXl3b3JkPjxrZXl3b3JkPklvbiBUcmFuc3BvcnQvZ2VuZXRpY3M8L2tleXdv

cmQ+PGtleXdvcmQ+SmFwYW4vZXBpZGVtaW9sb2d5PC9rZXl3b3JkPjxrZXl3b3JkPktDTlExIFBv

dGFzc2l1bSBDaGFubmVsL2NoZW1pc3RyeS8qZ2VuZXRpY3MvcGh5c2lvbG9neTwva2V5d29yZD48

a2V5d29yZD5LYXBsYW4tTWVpZXJzIEVzdGltYXRlPC9rZXl3b3JkPjxrZXl3b3JkPk1hbGU8L2tl

eXdvcmQ+PGtleXdvcmQ+TWVtYnJhbmUgUG90ZW50aWFsczwva2V5d29yZD48a2V5d29yZD5Nb2Rl

bHMsIE1vbGVjdWxhcjwva2V5d29yZD48a2V5d29yZD5NdXRhZ2VuZXNpcywgSW5zZXJ0aW9uYWw8

L2tleXdvcmQ+PGtleXdvcmQ+Kk11dGF0aW9uPC9rZXl3b3JkPjxrZXl3b3JkPk11dGF0aW9uLCBN

aXNzZW5zZTwva2V5d29yZD48a2V5d29yZD5OZXRoZXJsYW5kcy9lcGlkZW1pb2xvZ3k8L2tleXdv

cmQ+PGtleXdvcmQ+UGhlbm90eXBlPC9rZXl3b3JkPjxrZXl3b3JkPlBvdGFzc2l1bS9tZXRhYm9s

aXNtPC9rZXl3b3JkPjxrZXl3b3JkPlByb3BvcnRpb25hbCBIYXphcmRzIE1vZGVsczwva2V5d29y

ZD48a2V5d29yZD5Qcm90ZWluIFN0cnVjdHVyZSwgVGVydGlhcnk8L2tleXdvcmQ+PGtleXdvcmQ+

UHJvdGVpbiBUcmFuc3BvcnQ8L2tleXdvcmQ+PGtleXdvcmQ+Uk5BIFNwbGljZSBTaXRlcy9nZW5l

dGljczwva2V5d29yZD48a2V5d29yZD5SZWdpc3RyaWVzPC9rZXl3b3JkPjxrZXl3b3JkPlJpc2sg

RmFjdG9yczwva2V5d29yZD48a2V5d29yZD5Sb21hbm8tV2FyZCBTeW5kcm9tZS9jb21wbGljYXRp

b25zL2RydWcgdGhlcmFweS8qZ2VuZXRpY3MvbW9ydGFsaXR5PC9rZXl3b3JkPjxrZXl3b3JkPlNl

cXVlbmNlIERlbGV0aW9uPC9rZXl3b3JkPjxrZXl3b3JkPlN5bmNvcGUvZXBpZGVtaW9sb2d5PC9r

ZXl3b3JkPjxrZXl3b3JkPlVuaXRlZCBTdGF0ZXMvZXBpZGVtaW9sb2d5PC9rZXl3b3JkPjwva2V5

d29yZHM+PGRhdGVzPjx5ZWFyPjIwMDc8L3llYXI+PHB1Yi1kYXRlcz48ZGF0ZT5NYXkgMTU8L2Rh

dGU+PC9wdWItZGF0ZXM+PC9kYXRlcz48aXNibj4xNTI0LTQ1MzkgKEVsZWN0cm9uaWMpPC9pc2Ju

PjxhY2Nlc3Npb24tbnVtPjE3NDcwNjk1PC9hY2Nlc3Npb24tbnVtPjx1cmxzPjxyZWxhdGVkLXVy

bHM+PHVybD5odHRwOi8vd3d3Lm5jYmkubmxtLm5paC5nb3YvZW50cmV6L3F1ZXJ5LmZjZ2k/Y21k

PVJldHJpZXZlJmFtcDtkYj1QdWJNZWQmYW1wO2RvcHQ9Q2l0YXRpb24mYW1wO2xpc3RfdWlkcz0x

NzQ3MDY5NTwvdXJsPjwvcmVsYXRlZC11cmxzPjwvdXJscz48ZWxlY3Ryb25pYy1yZXNvdXJjZS1u

dW0+Q0lSQ1VMQVRJT05BSEEuMTA2LjY2NTQwNiBbcGlpXSYjeEQ7MTAuMTE2MS9DSVJDVUxBVElP

TkFIQS4xMDYuNjY1NDA2PC9lbGVjdHJvbmljLXJlc291cmNlLW51bT48bGFuZ3VhZ2U+ZW5nPC9s

YW5ndWFnZT48L3JlY29yZD48L0NpdGU+PENpdGU+PEF1dGhvcj5Nb3NzPC9BdXRob3I+PFllYXI+

MjAwMjwvWWVhcj48UmVjTnVtPjMwNTk8L1JlY051bT48cmVjb3JkPjxyZWMtbnVtYmVyPjMwNTk8

L3JlYy1udW1iZXI+PGZvcmVpZ24ta2V5cz48a2V5IGFwcD0iRU4iIGRiLWlkPSJmcjB0enBwMnY5

eHRwb2V3YTUycDBldnFzejJkdnZzdDlzZDAiPjMwNTk8L2tleT48L2ZvcmVpZ24ta2V5cz48cmVm

LXR5cGUgbmFtZT0iSm91cm5hbCBBcnRpY2xlIj4xNzwvcmVmLXR5cGU+PGNvbnRyaWJ1dG9ycz48

YXV0aG9ycz48YXV0aG9yPk1vc3MsIEEuIEouPC9hdXRob3I+PGF1dGhvcj5aYXJlYmEsIFcuPC9h

dXRob3I+PGF1dGhvcj5LYXVmbWFuLCBFLiBTLjwvYXV0aG9yPjxhdXRob3I+R2FydG1hbiwgRS48

L2F1dGhvcj48YXV0aG9yPlBldGVyc29uLCBELiBSLjwvYXV0aG9yPjxhdXRob3I+QmVuaG9yaW4s

IEouPC9hdXRob3I+PGF1dGhvcj5Ub3diaW4sIEouIEEuPC9hdXRob3I+PGF1dGhvcj5LZWF0aW5n

LCBNLiBULjwvYXV0aG9yPjxhdXRob3I+UHJpb3JpLCBTLiBHLjwvYXV0aG9yPjxhdXRob3I+U2No

d2FydHosIFAuIEouPC9hdXRob3I+PGF1dGhvcj5WaW5jZW50LCBHLiBNLjwvYXV0aG9yPjxhdXRo

b3I+Um9iaW5zb24sIEouIEwuPC9hdXRob3I+PGF1dGhvcj5BbmRyZXdzLCBNLiBMLjwvYXV0aG9y

PjxhdXRob3I+RmVuZywgQy48L2F1dGhvcj48YXV0aG9yPkhhbGwsIFcuIEouPC9hdXRob3I+PGF1

dGhvcj5NZWRpbmEsIEEuPC9hdXRob3I+PGF1dGhvcj5aaGFuZywgTC48L2F1dGhvcj48YXV0aG9y

PldhbmcsIFouPC9hdXRob3I+PC9hdXRob3JzPjwvY29udHJpYnV0b3JzPjxhdXRoLWFkZHJlc3M+

Q2FyZGlvbG9neSBVbml0IG9mIHRoZSBEZXBhcnRtZW50IG9mIE1lZGljaW5lLCBVbml2ZXJzaXR5

IG9mIFJvY2hlc3RlciBNZWRpY2FsIENlbnRlciwgUm9jaGVzdGVyLCBOWSAxNDY0MiwgVVNBLiBo

ZWFydGFqbUBoZWFydC5yb2NoZXN0ZXIuZWR1PC9hdXRoLWFkZHJlc3M+PHRpdGxlcz48dGl0bGU+

SW5jcmVhc2VkIHJpc2sgb2YgYXJyaHl0aG1pYyBldmVudHMgaW4gbG9uZy1RVCBzeW5kcm9tZSB3

aXRoIG11dGF0aW9ucyBpbiB0aGUgcG9yZSByZWdpb24gb2YgdGhlIGh1bWFuIGV0aGVyLWEtZ28t

Z28tcmVsYXRlZCBnZW5lIHBvdGFzc2l1bSBjaGFubmVsPC90aXRsZT48c2Vjb25kYXJ5LXRpdGxl

PkNpcmN1bGF0aW9uPC9zZWNvbmRhcnktdGl0bGU+PC90aXRsZXM+PHBlcmlvZGljYWw+PGZ1bGwt

dGl0bGU+Q2lyY3VsYXRpb248L2Z1bGwtdGl0bGU+PC9wZXJpb2RpY2FsPjxwYWdlcz43OTQtOTwv

cGFnZXM+PHZvbHVtZT4xMDU8L3ZvbHVtZT48bnVtYmVyPjc8L251bWJlcj48ZWRpdGlvbj4yMDAy

LzAyLzIxPC9lZGl0aW9uPjxrZXl3b3Jkcz48a2V5d29yZD5BZG9sZXNjZW50PC9rZXl3b3JkPjxr

ZXl3b3JkPkFkdWx0PC9rZXl3b3JkPjxrZXl3b3JkPkFycmh5dGhtaWFzLCBDYXJkaWFjLypldGlv

bG9neS8qZ2VuZXRpY3M8L2tleXdvcmQ+PGtleXdvcmQ+QmluZGluZyBTaXRlcy9nZW5ldGljczwv

a2V5d29yZD48a2V5d29yZD4qQ2F0aW9uIFRyYW5zcG9ydCBQcm90ZWluczwva2V5d29yZD48a2V5

d29yZD5ETkEgTXV0YXRpb25hbCBBbmFseXNpczwva2V5d29yZD48a2V5d29yZD4qRE5BLUJpbmRp

bmcgUHJvdGVpbnM8L2tleXdvcmQ+PGtleXdvcmQ+RGlzZWFzZSBQcm9ncmVzc2lvbjwva2V5d29y

ZD48a2V5d29yZD5FbGVjdHJvY2FyZGlvZ3JhcGh5PC9rZXl3b3JkPjxrZXl3b3JkPkV0aGVyLUEt

R28tR28gUG90YXNzaXVtIENoYW5uZWxzPC9rZXl3b3JkPjxrZXl3b3JkPkZlbWFsZTwva2V5d29y

ZD48a2V5d29yZD5Gb2xsb3ctVXAgU3R1ZGllczwva2V5d29yZD48a2V5d29yZD5IdW1hbnM8L2tl

eXdvcmQ+PGtleXdvcmQ+TG9uZyBRVCBTeW5kcm9tZS8qY29tcGxpY2F0aW9ucy9kaWFnbm9zaXMv

KmdlbmV0aWNzPC9rZXl3b3JkPjxrZXl3b3JkPk1hbGU8L2tleXdvcmQ+PGtleXdvcmQ+TW9kZWxz

LCBNb2xlY3VsYXI8L2tleXdvcmQ+PGtleXdvcmQ+TXV0YXRpb248L2tleXdvcmQ+PGtleXdvcmQ+

T2RkcyBSYXRpbzwva2V5d29yZD48a2V5d29yZD5QaGVub3R5cGU8L2tleXdvcmQ+PGtleXdvcmQ+

UG90YXNzaXVtIENoYW5uZWxzLypnZW5ldGljczwva2V5d29yZD48a2V5d29yZD4qUG90YXNzaXVt

IENoYW5uZWxzLCBWb2x0YWdlLUdhdGVkPC9rZXl3b3JkPjxrZXl3b3JkPlByb2dub3Npczwva2V5

d29yZD48a2V5d29yZD5Qcm9wb3J0aW9uYWwgSGF6YXJkcyBNb2RlbHM8L2tleXdvcmQ+PGtleXdv

cmQ+UmVnaXN0cmllcy9zdGF0aXN0aWNzICZhbXA7IG51bWVyaWNhbCBkYXRhPC9rZXl3b3JkPjxr

ZXl3b3JkPlJlZ3Jlc3Npb24gQW5hbHlzaXM8L2tleXdvcmQ+PGtleXdvcmQ+UmlzayBBc3Nlc3Nt

ZW50L3N0YXRpc3RpY3MgJmFtcDsgbnVtZXJpY2FsIGRhdGE8L2tleXdvcmQ+PGtleXdvcmQ+U3Vy

dml2YWwgQW5hbHlzaXM8L2tleXdvcmQ+PGtleXdvcmQ+KlRyYW5zLUFjdGl2YXRvcnM8L2tleXdv

cmQ+PC9rZXl3b3Jkcz48ZGF0ZXM+PHllYXI+MjAwMjwveWVhcj48cHViLWRhdGVzPjxkYXRlPkZl

YiAxOTwvZGF0ZT48L3B1Yi1kYXRlcz48L2RhdGVzPjxpc2JuPjE1MjQtNDUzOSAoRWxlY3Ryb25p

Yyk8L2lzYm4+PGFjY2Vzc2lvbi1udW0+MTE4NTQxMTc8L2FjY2Vzc2lvbi1udW0+PHVybHM+PHJl

bGF0ZWQtdXJscz48dXJsPmh0dHA6Ly93d3cubmNiaS5ubG0ubmloLmdvdi9lbnRyZXovcXVlcnku

ZmNnaT9jbWQ9UmV0cmlldmUmYW1wO2RiPVB1Yk1lZCZhbXA7ZG9wdD1DaXRhdGlvbiZhbXA7bGlz

dF91aWRzPTExODU0MTE3PC91cmw+PC9yZWxhdGVkLXVybHM+PC91cmxzPjxsYW5ndWFnZT5lbmc8

L2xhbmd1YWdlPjwvcmVjb3JkPjwvQ2l0ZT48Q2l0ZT48QXV0aG9yPlNoaW1penU8L0F1dGhvcj48

WWVhcj4yMDA5PC9ZZWFyPjxSZWNOdW0+NTQyNjwvUmVjTnVtPjxyZWNvcmQ+PHJlYy1udW1iZXI+

NTQyNjwvcmVjLW51bWJlcj48Zm9yZWlnbi1rZXlzPjxrZXkgYXBwPSJFTiIgZGItaWQ9ImZyMHR6

cHAydjl4dHBvZXdhNTJwMGV2cXN6MmR2dnN0OXNkMCI+NTQyNjwva2V5PjwvZm9yZWlnbi1rZXlz

PjxyZWYtdHlwZSBuYW1lPSJKb3VybmFsIEFydGljbGUiPjE3PC9yZWYtdHlwZT48Y29udHJpYnV0

b3JzPjxhdXRob3JzPjxhdXRob3I+U2hpbWl6dSwgVy48L2F1dGhvcj48YXV0aG9yPk1vc3MsIEEu

IEouPC9hdXRob3I+PGF1dGhvcj5XaWxkZSwgQS4gQS4gTS48L2F1dGhvcj48YXV0aG9yPlRvd2Jp

biwgSi4gQS48L2F1dGhvcj48YXV0aG9yPkFja2VybWFuLCBNLiBKLjwvYXV0aG9yPjxhdXRob3I+

SmFudWFyeSwgQy4gVC48L2F1dGhvcj48YXV0aG9yPlRlc3RlciwgRC4gSi48L2F1dGhvcj48YXV0

aG9yPlphcmViYSwgVy48L2F1dGhvcj48YXV0aG9yPlJvYmluc29uLCBKLiBMLjwvYXV0aG9yPjxh

dXRob3I+UWksIE0uPC9hdXRob3I+PGF1dGhvcj5WaW5jZW50LCBHLiBNLjwvYXV0aG9yPjxhdXRo

b3I+S2F1Zm1hbiwgRS4gUy48L2F1dGhvcj48YXV0aG9yPkhvZm1hbiwgTi48L2F1dGhvcj48YXV0

aG9yPk5vZGEsIFQuPC9hdXRob3I+PGF1dGhvcj5LYW1ha3VyYSwgUy48L2F1dGhvcj48YXV0aG9y

Pk1peWFtb3RvLCBZLjwvYXV0aG9yPjxhdXRob3I+U2hhaCwgUy48L2F1dGhvcj48YXV0aG9yPkFt

aW4sIFYuPC9hdXRob3I+PGF1dGhvcj5Hb2xkZW5iZXJnLCBJLjwvYXV0aG9yPjxhdXRob3I+QW5k

cmV3cywgTS4gTC48L2F1dGhvcj48YXV0aG9yPk1jTml0dCwgUy48L2F1dGhvcj48L2F1dGhvcnM+

PC9jb250cmlidXRvcnM+PHRpdGxlcz48dGl0bGU+R2Vub3R5cGUtUGhlbm90eXBlIEFzcGVjdHMg

b2YgVHlwZSAyIExvbmcgUVQgU3luZHJvbWU8L3RpdGxlPjxzZWNvbmRhcnktdGl0bGU+SiBBbSBD

b2xsIENhcmRpb2w8L3NlY29uZGFyeS10aXRsZT48L3RpdGxlcz48cGVyaW9kaWNhbD48ZnVsbC10

aXRsZT5KIEFtIENvbGwgQ2FyZGlvbDwvZnVsbC10aXRsZT48L3BlcmlvZGljYWw+PHBhZ2VzPjIw

NTItMjA2Mi48L3BhZ2VzPjx2b2x1bWU+NTQ8L3ZvbHVtZT48ZGF0ZXM+PHllYXI+MjAwOTwveWVh

cj48L2RhdGVzPjx1cmxzPjwvdXJscz48L3JlY29yZD48L0NpdGU+PC9FbmROb3RlPgAA

ADDIN EN.CITE PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5Nb3NzPC9BdXRob3I+PFllYXI+MjAwNzwvWWVhcj48UmVj

TnVtPjEwMjA8L1JlY051bT48cmVjb3JkPjxyZWMtbnVtYmVyPjEwMjA8L3JlYy1udW1iZXI+PGZv

cmVpZ24ta2V5cz48a2V5IGFwcD0iRU4iIGRiLWlkPSJmcjB0enBwMnY5eHRwb2V3YTUycDBldnFz

ejJkdnZzdDlzZDAiPjEwMjA8L2tleT48L2ZvcmVpZ24ta2V5cz48cmVmLXR5cGUgbmFtZT0iSm91

cm5hbCBBcnRpY2xlIj4xNzwvcmVmLXR5cGU+PGNvbnRyaWJ1dG9ycz48YXV0aG9ycz48YXV0aG9y

Pk1vc3MsIEEuIEouPC9hdXRob3I+PGF1dGhvcj5TaGltaXp1LCBXLjwvYXV0aG9yPjxhdXRob3I+

V2lsZGUsIEEuIEEuPC9hdXRob3I+PGF1dGhvcj5Ub3diaW4sIEouIEEuPC9hdXRob3I+PGF1dGhv

cj5aYXJlYmEsIFcuPC9hdXRob3I+PGF1dGhvcj5Sb2JpbnNvbiwgSi4gTC48L2F1dGhvcj48YXV0

aG9yPlFpLCBNLjwvYXV0aG9yPjxhdXRob3I+VmluY2VudCwgRy4gTS48L2F1dGhvcj48YXV0aG9y

PkFja2VybWFuLCBNLiBKLjwvYXV0aG9yPjxhdXRob3I+S2F1Zm1hbiwgRS4gUy48L2F1dGhvcj48

YXV0aG9yPkhvZm1hbiwgTi48L2F1dGhvcj48YXV0aG9yPlNldGgsIFIuPC9hdXRob3I+PGF1dGhv

cj5LYW1ha3VyYSwgUy48L2F1dGhvcj48YXV0aG9yPk1peWFtb3RvLCBZLjwvYXV0aG9yPjxhdXRo

b3I+R29sZGVuYmVyZywgSS48L2F1dGhvcj48YXV0aG9yPkFuZHJld3MsIE0uIEwuPC9hdXRob3I+

PGF1dGhvcj5NY05pdHQsIFMuPC9hdXRob3I+PC9hdXRob3JzPjwvY29udHJpYnV0b3JzPjxhdXRo

LWFkZHJlc3M+Q2FyZGlvbG9neSBEaXZpc2lvbiwgRGVwYXJ0bWVudCBvZiBNZWRpY2luZSwgVW5p

dmVyc2l0eSBvZiBSb2NoZXN0ZXIgU2Nob29sIG9mIE1lZGljaW5lIGFuZCBEZW50aXN0cnksIFJv

Y2hlc3RlciwgTlksIFVTQS4gaGVhcnRham1AaGVhcnQucm9jaGVzdGVyLmVkdTwvYXV0aC1hZGRy

ZXNzPjx0aXRsZXM+PHRpdGxlPkNsaW5pY2FsIGFzcGVjdHMgb2YgdHlwZS0xIGxvbmctUVQgc3lu

ZHJvbWUgYnkgbG9jYXRpb24sIGNvZGluZyB0eXBlLCBhbmQgYmlvcGh5c2ljYWwgZnVuY3Rpb24g

b2YgbXV0YXRpb25zIGludm9sdmluZyB0aGUgS0NOUTEgZ2VuZTwvdGl0bGU+PHNlY29uZGFyeS10

aXRsZT5DaXJjdWxhdGlvbjwvc2Vjb25kYXJ5LXRpdGxlPjwvdGl0bGVzPjxwZXJpb2RpY2FsPjxm

dWxsLXRpdGxlPkNpcmN1bGF0aW9uPC9mdWxsLXRpdGxlPjwvcGVyaW9kaWNhbD48cGFnZXM+MjQ4

MS05PC9wYWdlcz48dm9sdW1lPjExNTwvdm9sdW1lPjxudW1iZXI+MTk8L251bWJlcj48ZWRpdGlv

bj4yMDA3LzA1LzAyPC9lZGl0aW9uPjxrZXl3b3Jkcz48a2V5d29yZD5BZG9sZXNjZW50PC9rZXl3

b3JkPjxrZXl3b3JkPkFkcmVuZXJnaWMgYmV0YS1BbnRhZ29uaXN0cy90aGVyYXBldXRpYyB1c2U8

L2tleXdvcmQ+PGtleXdvcmQ+QWR1bHQ8L2tleXdvcmQ+PGtleXdvcmQ+Q2hpbGQ8L2tleXdvcmQ+

PGtleXdvcmQ+Q2hpbGQsIFByZXNjaG9vbDwva2V5d29yZD48a2V5d29yZD5Db2RvbiwgTm9uc2Vu

c2U8L2tleXdvcmQ+PGtleXdvcmQ+RGVhdGgsIFN1ZGRlbiwgQ2FyZGlhYy9lcGlkZW1pb2xvZ3kv

cHJldmVudGlvbiAmYW1wOyBjb250cm9sPC9rZXl3b3JkPjxrZXl3b3JkPkZlbWFsZTwva2V5d29y

ZD48a2V5d29yZD5GcmFtZXNoaWZ0IE11dGF0aW9uPC9rZXl3b3JkPjxrZXl3b3JkPkdlbmV0aWMg

UHJlZGlzcG9zaXRpb24gdG8gRGlzZWFzZTwva2V5d29yZD48a2V5d29yZD5HZW5vdHlwZTwva2V5

d29yZD48a2V5d29yZD5IZWFydCBBcnJlc3QvZXBpZGVtaW9sb2d5PC9rZXl3b3JkPjxrZXl3b3Jk

Pkh1bWFuczwva2V5d29yZD48a2V5d29yZD5JbmZhbnQ8L2tleXdvcmQ+PGtleXdvcmQ+SW5mYW50

LCBOZXdib3JuPC9rZXl3b3JkPjxrZXl3b3JkPklvbiBUcmFuc3BvcnQvZ2VuZXRpY3M8L2tleXdv

cmQ+PGtleXdvcmQ+SmFwYW4vZXBpZGVtaW9sb2d5PC9rZXl3b3JkPjxrZXl3b3JkPktDTlExIFBv

dGFzc2l1bSBDaGFubmVsL2NoZW1pc3RyeS8qZ2VuZXRpY3MvcGh5c2lvbG9neTwva2V5d29yZD48

a2V5d29yZD5LYXBsYW4tTWVpZXJzIEVzdGltYXRlPC9rZXl3b3JkPjxrZXl3b3JkPk1hbGU8L2tl

eXdvcmQ+PGtleXdvcmQ+TWVtYnJhbmUgUG90ZW50aWFsczwva2V5d29yZD48a2V5d29yZD5Nb2Rl

bHMsIE1vbGVjdWxhcjwva2V5d29yZD48a2V5d29yZD5NdXRhZ2VuZXNpcywgSW5zZXJ0aW9uYWw8

L2tleXdvcmQ+PGtleXdvcmQ+Kk11dGF0aW9uPC9rZXl3b3JkPjxrZXl3b3JkPk11dGF0aW9uLCBN

aXNzZW5zZTwva2V5d29yZD48a2V5d29yZD5OZXRoZXJsYW5kcy9lcGlkZW1pb2xvZ3k8L2tleXdv

cmQ+PGtleXdvcmQ+UGhlbm90eXBlPC9rZXl3b3JkPjxrZXl3b3JkPlBvdGFzc2l1bS9tZXRhYm9s

aXNtPC9rZXl3b3JkPjxrZXl3b3JkPlByb3BvcnRpb25hbCBIYXphcmRzIE1vZGVsczwva2V5d29y

ZD48a2V5d29yZD5Qcm90ZWluIFN0cnVjdHVyZSwgVGVydGlhcnk8L2tleXdvcmQ+PGtleXdvcmQ+

UHJvdGVpbiBUcmFuc3BvcnQ8L2tleXdvcmQ+PGtleXdvcmQ+Uk5BIFNwbGljZSBTaXRlcy9nZW5l

dGljczwva2V5d29yZD48a2V5d29yZD5SZWdpc3RyaWVzPC9rZXl3b3JkPjxrZXl3b3JkPlJpc2sg

RmFjdG9yczwva2V5d29yZD48a2V5d29yZD5Sb21hbm8tV2FyZCBTeW5kcm9tZS9jb21wbGljYXRp

b25zL2RydWcgdGhlcmFweS8qZ2VuZXRpY3MvbW9ydGFsaXR5PC9rZXl3b3JkPjxrZXl3b3JkPlNl

cXVlbmNlIERlbGV0aW9uPC9rZXl3b3JkPjxrZXl3b3JkPlN5bmNvcGUvZXBpZGVtaW9sb2d5PC9r

ZXl3b3JkPjxrZXl3b3JkPlVuaXRlZCBTdGF0ZXMvZXBpZGVtaW9sb2d5PC9rZXl3b3JkPjwva2V5

d29yZHM+PGRhdGVzPjx5ZWFyPjIwMDc8L3llYXI+PHB1Yi1kYXRlcz48ZGF0ZT5NYXkgMTU8L2Rh

dGU+PC9wdWItZGF0ZXM+PC9kYXRlcz48aXNibj4xNTI0LTQ1MzkgKEVsZWN0cm9uaWMpPC9pc2Ju

PjxhY2Nlc3Npb24tbnVtPjE3NDcwNjk1PC9hY2Nlc3Npb24tbnVtPjx1cmxzPjxyZWxhdGVkLXVy

bHM+PHVybD5odHRwOi8vd3d3Lm5jYmkubmxtLm5paC5nb3YvZW50cmV6L3F1ZXJ5LmZjZ2k/Y21k

PVJldHJpZXZlJmFtcDtkYj1QdWJNZWQmYW1wO2RvcHQ9Q2l0YXRpb24mYW1wO2xpc3RfdWlkcz0x

NzQ3MDY5NTwvdXJsPjwvcmVsYXRlZC11cmxzPjwvdXJscz48ZWxlY3Ryb25pYy1yZXNvdXJjZS1u

dW0+Q0lSQ1VMQVRJT05BSEEuMTA2LjY2NTQwNiBbcGlpXSYjeEQ7MTAuMTE2MS9DSVJDVUxBVElP

TkFIQS4xMDYuNjY1NDA2PC9lbGVjdHJvbmljLXJlc291cmNlLW51bT48bGFuZ3VhZ2U+ZW5nPC9s

YW5ndWFnZT48L3JlY29yZD48L0NpdGU+PENpdGU+PEF1dGhvcj5Nb3NzPC9BdXRob3I+PFllYXI+

MjAwMjwvWWVhcj48UmVjTnVtPjMwNTk8L1JlY051bT48cmVjb3JkPjxyZWMtbnVtYmVyPjMwNTk8

L3JlYy1udW1iZXI+PGZvcmVpZ24ta2V5cz48a2V5IGFwcD0iRU4iIGRiLWlkPSJmcjB0enBwMnY5

eHRwb2V3YTUycDBldnFzejJkdnZzdDlzZDAiPjMwNTk8L2tleT48L2ZvcmVpZ24ta2V5cz48cmVm

LXR5cGUgbmFtZT0iSm91cm5hbCBBcnRpY2xlIj4xNzwvcmVmLXR5cGU+PGNvbnRyaWJ1dG9ycz48

YXV0aG9ycz48YXV0aG9yPk1vc3MsIEEuIEouPC9hdXRob3I+PGF1dGhvcj5aYXJlYmEsIFcuPC9h

dXRob3I+PGF1dGhvcj5LYXVmbWFuLCBFLiBTLjwvYXV0aG9yPjxhdXRob3I+R2FydG1hbiwgRS48

L2F1dGhvcj48YXV0aG9yPlBldGVyc29uLCBELiBSLjwvYXV0aG9yPjxhdXRob3I+QmVuaG9yaW4s

IEouPC9hdXRob3I+PGF1dGhvcj5Ub3diaW4sIEouIEEuPC9hdXRob3I+PGF1dGhvcj5LZWF0aW5n

LCBNLiBULjwvYXV0aG9yPjxhdXRob3I+UHJpb3JpLCBTLiBHLjwvYXV0aG9yPjxhdXRob3I+U2No

d2FydHosIFAuIEouPC9hdXRob3I+PGF1dGhvcj5WaW5jZW50LCBHLiBNLjwvYXV0aG9yPjxhdXRo

b3I+Um9iaW5zb24sIEouIEwuPC9hdXRob3I+PGF1dGhvcj5BbmRyZXdzLCBNLiBMLjwvYXV0aG9y

PjxhdXRob3I+RmVuZywgQy48L2F1dGhvcj48YXV0aG9yPkhhbGwsIFcuIEouPC9hdXRob3I+PGF1

dGhvcj5NZWRpbmEsIEEuPC9hdXRob3I+PGF1dGhvcj5aaGFuZywgTC48L2F1dGhvcj48YXV0aG9y

PldhbmcsIFouPC9hdXRob3I+PC9hdXRob3JzPjwvY29udHJpYnV0b3JzPjxhdXRoLWFkZHJlc3M+

Q2FyZGlvbG9neSBVbml0IG9mIHRoZSBEZXBhcnRtZW50IG9mIE1lZGljaW5lLCBVbml2ZXJzaXR5

IG9mIFJvY2hlc3RlciBNZWRpY2FsIENlbnRlciwgUm9jaGVzdGVyLCBOWSAxNDY0MiwgVVNBLiBo

ZWFydGFqbUBoZWFydC5yb2NoZXN0ZXIuZWR1PC9hdXRoLWFkZHJlc3M+PHRpdGxlcz48dGl0bGU+

SW5jcmVhc2VkIHJpc2sgb2YgYXJyaHl0aG1pYyBldmVudHMgaW4gbG9uZy1RVCBzeW5kcm9tZSB3

aXRoIG11dGF0aW9ucyBpbiB0aGUgcG9yZSByZWdpb24gb2YgdGhlIGh1bWFuIGV0aGVyLWEtZ28t

Z28tcmVsYXRlZCBnZW5lIHBvdGFzc2l1bSBjaGFubmVsPC90aXRsZT48c2Vjb25kYXJ5LXRpdGxl

PkNpcmN1bGF0aW9uPC9zZWNvbmRhcnktdGl0bGU+PC90aXRsZXM+PHBlcmlvZGljYWw+PGZ1bGwt

dGl0bGU+Q2lyY3VsYXRpb248L2Z1bGwtdGl0bGU+PC9wZXJpb2RpY2FsPjxwYWdlcz43OTQtOTwv

cGFnZXM+PHZvbHVtZT4xMDU8L3ZvbHVtZT48bnVtYmVyPjc8L251bWJlcj48ZWRpdGlvbj4yMDAy

LzAyLzIxPC9lZGl0aW9uPjxrZXl3b3Jkcz48a2V5d29yZD5BZG9sZXNjZW50PC9rZXl3b3JkPjxr

ZXl3b3JkPkFkdWx0PC9rZXl3b3JkPjxrZXl3b3JkPkFycmh5dGhtaWFzLCBDYXJkaWFjLypldGlv

bG9neS8qZ2VuZXRpY3M8L2tleXdvcmQ+PGtleXdvcmQ+QmluZGluZyBTaXRlcy9nZW5ldGljczwv

a2V5d29yZD48a2V5d29yZD4qQ2F0aW9uIFRyYW5zcG9ydCBQcm90ZWluczwva2V5d29yZD48a2V5

d29yZD5ETkEgTXV0YXRpb25hbCBBbmFseXNpczwva2V5d29yZD48a2V5d29yZD4qRE5BLUJpbmRp

bmcgUHJvdGVpbnM8L2tleXdvcmQ+PGtleXdvcmQ+RGlzZWFzZSBQcm9ncmVzc2lvbjwva2V5d29y

ZD48a2V5d29yZD5FbGVjdHJvY2FyZGlvZ3JhcGh5PC9rZXl3b3JkPjxrZXl3b3JkPkV0aGVyLUEt

R28tR28gUG90YXNzaXVtIENoYW5uZWxzPC9rZXl3b3JkPjxrZXl3b3JkPkZlbWFsZTwva2V5d29y

ZD48a2V5d29yZD5Gb2xsb3ctVXAgU3R1ZGllczwva2V5d29yZD48a2V5d29yZD5IdW1hbnM8L2tl

eXdvcmQ+PGtleXdvcmQ+TG9uZyBRVCBTeW5kcm9tZS8qY29tcGxpY2F0aW9ucy9kaWFnbm9zaXMv

KmdlbmV0aWNzPC9rZXl3b3JkPjxrZXl3b3JkPk1hbGU8L2tleXdvcmQ+PGtleXdvcmQ+TW9kZWxz

LCBNb2xlY3VsYXI8L2tleXdvcmQ+PGtleXdvcmQ+TXV0YXRpb248L2tleXdvcmQ+PGtleXdvcmQ+

T2RkcyBSYXRpbzwva2V5d29yZD48a2V5d29yZD5QaGVub3R5cGU8L2tleXdvcmQ+PGtleXdvcmQ+

UG90YXNzaXVtIENoYW5uZWxzLypnZW5ldGljczwva2V5d29yZD48a2V5d29yZD4qUG90YXNzaXVt

IENoYW5uZWxzLCBWb2x0YWdlLUdhdGVkPC9rZXl3b3JkPjxrZXl3b3JkPlByb2dub3Npczwva2V5

d29yZD48a2V5d29yZD5Qcm9wb3J0aW9uYWwgSGF6YXJkcyBNb2RlbHM8L2tleXdvcmQ+PGtleXdv

cmQ+UmVnaXN0cmllcy9zdGF0aXN0aWNzICZhbXA7IG51bWVyaWNhbCBkYXRhPC9rZXl3b3JkPjxr

ZXl3b3JkPlJlZ3Jlc3Npb24gQW5hbHlzaXM8L2tleXdvcmQ+PGtleXdvcmQ+UmlzayBBc3Nlc3Nt

ZW50L3N0YXRpc3RpY3MgJmFtcDsgbnVtZXJpY2FsIGRhdGE8L2tleXdvcmQ+PGtleXdvcmQ+U3Vy

dml2YWwgQW5hbHlzaXM8L2tleXdvcmQ+PGtleXdvcmQ+KlRyYW5zLUFjdGl2YXRvcnM8L2tleXdv

cmQ+PC9rZXl3b3Jkcz48ZGF0ZXM+PHllYXI+MjAwMjwveWVhcj48cHViLWRhdGVzPjxkYXRlPkZl

YiAxOTwvZGF0ZT48L3B1Yi1kYXRlcz48L2RhdGVzPjxpc2JuPjE1MjQtNDUzOSAoRWxlY3Ryb25p

Yyk8L2lzYm4+PGFjY2Vzc2lvbi1udW0+MTE4NTQxMTc8L2FjY2Vzc2lvbi1udW0+PHVybHM+PHJl

bGF0ZWQtdXJscz48dXJsPmh0dHA6Ly93d3cubmNiaS5ubG0ubmloLmdvdi9lbnRyZXovcXVlcnku

ZmNnaT9jbWQ9UmV0cmlldmUmYW1wO2RiPVB1Yk1lZCZhbXA7ZG9wdD1DaXRhdGlvbiZhbXA7bGlz

dF91aWRzPTExODU0MTE3PC91cmw+PC9yZWxhdGVkLXVybHM+PC91cmxzPjxsYW5ndWFnZT5lbmc8

L2xhbmd1YWdlPjwvcmVjb3JkPjwvQ2l0ZT48Q2l0ZT48QXV0aG9yPlNoaW1penU8L0F1dGhvcj48

WWVhcj4yMDA5PC9ZZWFyPjxSZWNOdW0+NTQyNjwvUmVjTnVtPjxyZWNvcmQ+PHJlYy1udW1iZXI+

NTQyNjwvcmVjLW51bWJlcj48Zm9yZWlnbi1rZXlzPjxrZXkgYXBwPSJFTiIgZGItaWQ9ImZyMHR6

cHAydjl4dHBvZXdhNTJwMGV2cXN6MmR2dnN0OXNkMCI+NTQyNjwva2V5PjwvZm9yZWlnbi1rZXlz

PjxyZWYtdHlwZSBuYW1lPSJKb3VybmFsIEFydGljbGUiPjE3PC9yZWYtdHlwZT48Y29udHJpYnV0

b3JzPjxhdXRob3JzPjxhdXRob3I+U2hpbWl6dSwgVy48L2F1dGhvcj48YXV0aG9yPk1vc3MsIEEu

IEouPC9hdXRob3I+PGF1dGhvcj5XaWxkZSwgQS4gQS4gTS48L2F1dGhvcj48YXV0aG9yPlRvd2Jp

biwgSi4gQS48L2F1dGhvcj48YXV0aG9yPkFja2VybWFuLCBNLiBKLjwvYXV0aG9yPjxhdXRob3I+

SmFudWFyeSwgQy4gVC48L2F1dGhvcj48YXV0aG9yPlRlc3RlciwgRC4gSi48L2F1dGhvcj48YXV0

aG9yPlphcmViYSwgVy48L2F1dGhvcj48YXV0aG9yPlJvYmluc29uLCBKLiBMLjwvYXV0aG9yPjxh

dXRob3I+UWksIE0uPC9hdXRob3I+PGF1dGhvcj5WaW5jZW50LCBHLiBNLjwvYXV0aG9yPjxhdXRo

b3I+S2F1Zm1hbiwgRS4gUy48L2F1dGhvcj48YXV0aG9yPkhvZm1hbiwgTi48L2F1dGhvcj48YXV0

aG9yPk5vZGEsIFQuPC9hdXRob3I+PGF1dGhvcj5LYW1ha3VyYSwgUy48L2F1dGhvcj48YXV0aG9y

Pk1peWFtb3RvLCBZLjwvYXV0aG9yPjxhdXRob3I+U2hhaCwgUy48L2F1dGhvcj48YXV0aG9yPkFt

aW4sIFYuPC9hdXRob3I+PGF1dGhvcj5Hb2xkZW5iZXJnLCBJLjwvYXV0aG9yPjxhdXRob3I+QW5k

cmV3cywgTS4gTC48L2F1dGhvcj48YXV0aG9yPk1jTml0dCwgUy48L2F1dGhvcj48L2F1dGhvcnM+

PC9jb250cmlidXRvcnM+PHRpdGxlcz48dGl0bGU+R2Vub3R5cGUtUGhlbm90eXBlIEFzcGVjdHMg

b2YgVHlwZSAyIExvbmcgUVQgU3luZHJvbWU8L3RpdGxlPjxzZWNvbmRhcnktdGl0bGU+SiBBbSBD

b2xsIENhcmRpb2w8L3NlY29uZGFyeS10aXRsZT48L3RpdGxlcz48cGVyaW9kaWNhbD48ZnVsbC10

aXRsZT5KIEFtIENvbGwgQ2FyZGlvbDwvZnVsbC10aXRsZT48L3BlcmlvZGljYWw+PHBhZ2VzPjIw

NTItMjA2Mi48L3BhZ2VzPjx2b2x1bWU+NTQ8L3ZvbHVtZT48ZGF0ZXM+PHllYXI+MjAwOTwveWVh

cj48L2RhdGVzPjx1cmxzPjwvdXJscz48L3JlY29yZD48L0NpdGU+PC9FbmROb3RlPgAA

ADDIN EN.CITE.DATA 36-38. We recommend that cases of LQTS where an ICD may be contemplated for primary prevention should be discussed at a multi-disciplinary meeting, such as quarterly meeting held in our network.The following section on ganglionectomy is taken directly from the ACC/AHA/ESC guidelinesPEVuZE5vdGU+PENpdGU+PEF1dGhvcj5aaXBlczwvQXV0aG9yPjxZZWFyPjIwMDY8L1llYXI+PFJl

Y051bT41NDI3PC9SZWNOdW0+PHJlY29yZD48cmVjLW51bWJlcj41NDI3PC9yZWMtbnVtYmVyPjxm

b3JlaWduLWtleXM+PGtleSBhcHA9IkVOIiBkYi1pZD0iZnIwdHpwcDJ2OXh0cG9ld2E1MnAwZXZx

c3oyZHZ2c3Q5c2QwIj41NDI3PC9rZXk+PC9mb3JlaWduLWtleXM+PHJlZi10eXBlIG5hbWU9Ikpv

dXJuYWwgQXJ0aWNsZSI+MTc8L3JlZi10eXBlPjxjb250cmlidXRvcnM+PGF1dGhvcnM+PGF1dGhv

cj5aaXBlcywgRC4gUC48L2F1dGhvcj48YXV0aG9yPkNhbW0sIEEuIEouPC9hdXRob3I+PGF1dGhv

cj5Cb3JnZ3JlZmUsIE0uPC9hdXRob3I+PGF1dGhvcj5CdXh0b24sIEEuIEUuPC9hdXRob3I+PGF1

dGhvcj5DaGFpdG1hbiwgQi48L2F1dGhvcj48YXV0aG9yPkZyb21lciwgTS48L2F1dGhvcj48YXV0

aG9yPkdyZWdvcmF0b3MsIEcuPC9hdXRob3I+PGF1dGhvcj5LbGVpbiwgRy48L2F1dGhvcj48YXV0

aG9yPk1vc3MsIEEuIEouPC9hdXRob3I+PGF1dGhvcj5NeWVyYnVyZywgUi4gSi48L2F1dGhvcj48

YXV0aG9yPlByaW9yaSwgUy4gRy48L2F1dGhvcj48YXV0aG9yPlF1aW5vbmVzLCBNLiBBLjwvYXV0

aG9yPjxhdXRob3I+Um9kZW4sIEQuIE0uPC9hdXRob3I+PGF1dGhvcj5TaWxrYSwgTS4gSi48L2F1

dGhvcj48YXV0aG9yPlRyYWN5LCBDLjwvYXV0aG9yPjxhdXRob3I+U21pdGgsIFMuIEMuLCBKci48

L2F1dGhvcj48YXV0aG9yPkphY29icywgQS4gSy48L2F1dGhvcj48YXV0aG9yPkFkYW1zLCBDLiBE

LjwvYXV0aG9yPjxhdXRob3I+QW50bWFuLCBFLiBNLjwvYXV0aG9yPjxhdXRob3I+QW5kZXJzb24s

IEouIEwuPC9hdXRob3I+PGF1dGhvcj5IdW50LCBTLiBBLjwvYXV0aG9yPjxhdXRob3I+SGFscGVy

aW4sIEouIEwuPC9hdXRob3I+PGF1dGhvcj5OaXNoaW11cmEsIFIuPC9hdXRob3I+PGF1dGhvcj5P

cm5hdG8sIEouIFAuPC9hdXRob3I+PGF1dGhvcj5QYWdlLCBSLiBMLjwvYXV0aG9yPjxhdXRob3I+

UmllZ2VsLCBCLjwvYXV0aG9yPjxhdXRob3I+QmxhbmMsIEouIEouPC9hdXRob3I+PGF1dGhvcj5C

dWRhaiwgQS48L2F1dGhvcj48YXV0aG9yPkRlYW4sIFYuPC9hdXRob3I+PGF1dGhvcj5EZWNrZXJz

LCBKLiBXLjwvYXV0aG9yPjxhdXRob3I+RGVzcHJlcywgQy48L2F1dGhvcj48YXV0aG9yPkRpY2tz

dGVpbiwgSy48L2F1dGhvcj48YXV0aG9yPkxla2FraXMsIEouPC9hdXRob3I+PGF1dGhvcj5NY0dy

ZWdvciwgSy48L2F1dGhvcj48YXV0aG9yPk1ldHJhLCBNLjwvYXV0aG9yPjxhdXRob3I+TW9yYWlz

LCBKLjwvYXV0aG9yPjxhdXRob3I+T3N0ZXJzcGV5LCBBLjwvYXV0aG9yPjxhdXRob3I+VGFtYXJn

bywgSi4gTC48L2F1dGhvcj48YXV0aG9yPlphbW9yYW5vLCBKLiBMLjwvYXV0aG9yPjwvYXV0aG9y

cz48L2NvbnRyaWJ1dG9ycz48dGl0bGVzPjx0aXRsZT5BQ0MvQUhBL0VTQyAyMDA2IEd1aWRlbGlu

ZXMgZm9yIE1hbmFnZW1lbnQgb2YgUGF0aWVudHMgV2l0aCBWZW50cmljdWxhciBBcnJoeXRobWlh

cyBhbmQgdGhlIFByZXZlbnRpb24gb2YgU3VkZGVuIENhcmRpYWMgRGVhdGg6IGEgcmVwb3J0IG9m

IHRoZSBBbWVyaWNhbiBDb2xsZWdlIG9mIENhcmRpb2xvZ3kvQW1lcmljYW4gSGVhcnQgQXNzb2Np

YXRpb24gVGFzayBGb3JjZSBhbmQgdGhlIEV1cm9wZWFuIFNvY2lldHkgb2YgQ2FyZGlvbG9neSBD

b21taXR0ZWUgZm9yIFByYWN0aWNlIEd1aWRlbGluZXMgKHdyaXRpbmcgY29tbWl0dGVlIHRvIGRl

dmVsb3AgR3VpZGVsaW5lcyBmb3IgTWFuYWdlbWVudCBvZiBQYXRpZW50cyBXaXRoIFZlbnRyaWN1

bGFyIEFycmh5dGhtaWFzIGFuZCB0aGUgUHJldmVudGlvbiBvZiBTdWRkZW4gQ2FyZGlhYyBEZWF0

aCk6IGRldmVsb3BlZCBpbiBjb2xsYWJvcmF0aW9uIHdpdGggdGhlIEV1cm9wZWFuIEhlYXJ0IFJo

eXRobSBBc3NvY2lhdGlvbiBhbmQgdGhlIEhlYXJ0IFJoeXRobSBTb2NpZXR5PC90aXRsZT48c2Vj

b25kYXJ5LXRpdGxlPkNpcmN1bGF0aW9uPC9zZWNvbmRhcnktdGl0bGU+PC90aXRsZXM+PHBlcmlv

ZGljYWw+PGZ1bGwtdGl0bGU+Q2lyY3VsYXRpb248L2Z1bGwtdGl0bGU+PC9wZXJpb2RpY2FsPjxw

YWdlcz5lMzg1LTQ4NDwvcGFnZXM+PHZvbHVtZT4xMTQ8L3ZvbHVtZT48bnVtYmVyPjEwPC9udW1i

ZXI+PGtleXdvcmRzPjxrZXl3b3JkPkFtZXJpY2FuIEhlYXJ0IEFzc29jaWF0aW9uPC9rZXl3b3Jk

PjxrZXl3b3JkPkFycmh5dGhtaWEvKnRoZXJhcHk8L2tleXdvcmQ+PGtleXdvcmQ+RGVhdGgsIFN1

ZGRlbiwgQ2FyZGlhYy8qcHJldmVudGlvbiAmYW1wOyBjb250cm9sPC9rZXl3b3JkPjxrZXl3b3Jk

PkV1cm9wZTwva2V5d29yZD48a2V5d29yZD5IdW1hbnM8L2tleXdvcmQ+PGtleXdvcmQ+UXVhbGl0

eSBBc3N1cmFuY2UsIEhlYWx0aCBDYXJlPC9rZXl3b3JkPjxrZXl3b3JkPlNvY2lldGllcywgTWVk

aWNhbDwva2V5d29yZD48a2V5d29yZD5WZW50cmljdWxhciBEeXNmdW5jdGlvbi8qdGhlcmFweTwv

a2V5d29yZD48L2tleXdvcmRzPjxkYXRlcz48eWVhcj4yMDA2PC95ZWFyPjwvZGF0ZXM+PGFjY2Vz

c2lvbi1udW0+MTY5MzU5OTU8L2FjY2Vzc2lvbi1udW0+PHVybHM+PHJlbGF0ZWQtdXJscz48dXJs

Pmh0dHA6Ly93d3cubmNiaS5ubG0ubmloLmdvdi9lbnRyZXovcXVlcnkuZmNnaT9jbWQ9UmV0cmll

dmUmYW1wO2RiPVB1Yk1lZCZhbXA7ZG9wdD1DaXRhdGlvbiZhbXA7bGlzdF91aWRzPTE2OTM1OTk1

PC91cmw+PC9yZWxhdGVkLXVybHM+PC91cmxzPjwvcmVjb3JkPjwvQ2l0ZT48L0VuZE5vdGU+AAA=

ADDIN EN.CITE PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5aaXBlczwvQXV0aG9yPjxZZWFyPjIwMDY8L1llYXI+PFJl

Y051bT41NDI3PC9SZWNOdW0+PHJlY29yZD48cmVjLW51bWJlcj41NDI3PC9yZWMtbnVtYmVyPjxm

b3JlaWduLWtleXM+PGtleSBhcHA9IkVOIiBkYi1pZD0iZnIwdHpwcDJ2OXh0cG9ld2E1MnAwZXZx

c3oyZHZ2c3Q5c2QwIj41NDI3PC9rZXk+PC9mb3JlaWduLWtleXM+PHJlZi10eXBlIG5hbWU9Ikpv

dXJuYWwgQXJ0aWNsZSI+MTc8L3JlZi10eXBlPjxjb250cmlidXRvcnM+PGF1dGhvcnM+PGF1dGhv

cj5aaXBlcywgRC4gUC48L2F1dGhvcj48YXV0aG9yPkNhbW0sIEEuIEouPC9hdXRob3I+PGF1dGhv

cj5Cb3JnZ3JlZmUsIE0uPC9hdXRob3I+PGF1dGhvcj5CdXh0b24sIEEuIEUuPC9hdXRob3I+PGF1

dGhvcj5DaGFpdG1hbiwgQi48L2F1dGhvcj48YXV0aG9yPkZyb21lciwgTS48L2F1dGhvcj48YXV0

aG9yPkdyZWdvcmF0b3MsIEcuPC9hdXRob3I+PGF1dGhvcj5LbGVpbiwgRy48L2F1dGhvcj48YXV0

aG9yPk1vc3MsIEEuIEouPC9hdXRob3I+PGF1dGhvcj5NeWVyYnVyZywgUi4gSi48L2F1dGhvcj48

YXV0aG9yPlByaW9yaSwgUy4gRy48L2F1dGhvcj48YXV0aG9yPlF1aW5vbmVzLCBNLiBBLjwvYXV0

aG9yPjxhdXRob3I+Um9kZW4sIEQuIE0uPC9hdXRob3I+PGF1dGhvcj5TaWxrYSwgTS4gSi48L2F1

dGhvcj48YXV0aG9yPlRyYWN5LCBDLjwvYXV0aG9yPjxhdXRob3I+U21pdGgsIFMuIEMuLCBKci48

L2F1dGhvcj48YXV0aG9yPkphY29icywgQS4gSy48L2F1dGhvcj48YXV0aG9yPkFkYW1zLCBDLiBE

LjwvYXV0aG9yPjxhdXRob3I+QW50bWFuLCBFLiBNLjwvYXV0aG9yPjxhdXRob3I+QW5kZXJzb24s

IEouIEwuPC9hdXRob3I+PGF1dGhvcj5IdW50LCBTLiBBLjwvYXV0aG9yPjxhdXRob3I+SGFscGVy

aW4sIEouIEwuPC9hdXRob3I+PGF1dGhvcj5OaXNoaW11cmEsIFIuPC9hdXRob3I+PGF1dGhvcj5P

cm5hdG8sIEouIFAuPC9hdXRob3I+PGF1dGhvcj5QYWdlLCBSLiBMLjwvYXV0aG9yPjxhdXRob3I+

UmllZ2VsLCBCLjwvYXV0aG9yPjxhdXRob3I+QmxhbmMsIEouIEouPC9hdXRob3I+PGF1dGhvcj5C

dWRhaiwgQS48L2F1dGhvcj48YXV0aG9yPkRlYW4sIFYuPC9hdXRob3I+PGF1dGhvcj5EZWNrZXJz

LCBKLiBXLjwvYXV0aG9yPjxhdXRob3I+RGVzcHJlcywgQy48L2F1dGhvcj48YXV0aG9yPkRpY2tz

dGVpbiwgSy48L2F1dGhvcj48YXV0aG9yPkxla2FraXMsIEouPC9hdXRob3I+PGF1dGhvcj5NY0dy

ZWdvciwgSy48L2F1dGhvcj48YXV0aG9yPk1ldHJhLCBNLjwvYXV0aG9yPjxhdXRob3I+TW9yYWlz

LCBKLjwvYXV0aG9yPjxhdXRob3I+T3N0ZXJzcGV5LCBBLjwvYXV0aG9yPjxhdXRob3I+VGFtYXJn

bywgSi4gTC48L2F1dGhvcj48YXV0aG9yPlphbW9yYW5vLCBKLiBMLjwvYXV0aG9yPjwvYXV0aG9y

cz48L2NvbnRyaWJ1dG9ycz48dGl0bGVzPjx0aXRsZT5BQ0MvQUhBL0VTQyAyMDA2IEd1aWRlbGlu

ZXMgZm9yIE1hbmFnZW1lbnQgb2YgUGF0aWVudHMgV2l0aCBWZW50cmljdWxhciBBcnJoeXRobWlh

cyBhbmQgdGhlIFByZXZlbnRpb24gb2YgU3VkZGVuIENhcmRpYWMgRGVhdGg6IGEgcmVwb3J0IG9m

IHRoZSBBbWVyaWNhbiBDb2xsZWdlIG9mIENhcmRpb2xvZ3kvQW1lcmljYW4gSGVhcnQgQXNzb2Np

YXRpb24gVGFzayBGb3JjZSBhbmQgdGhlIEV1cm9wZWFuIFNvY2lldHkgb2YgQ2FyZGlvbG9neSBD

b21taXR0ZWUgZm9yIFByYWN0aWNlIEd1aWRlbGluZXMgKHdyaXRpbmcgY29tbWl0dGVlIHRvIGRl

dmVsb3AgR3VpZGVsaW5lcyBmb3IgTWFuYWdlbWVudCBvZiBQYXRpZW50cyBXaXRoIFZlbnRyaWN1

bGFyIEFycmh5dGhtaWFzIGFuZCB0aGUgUHJldmVudGlvbiBvZiBTdWRkZW4gQ2FyZGlhYyBEZWF0

aCk6IGRldmVsb3BlZCBpbiBjb2xsYWJvcmF0aW9uIHdpdGggdGhlIEV1cm9wZWFuIEhlYXJ0IFJo

eXRobSBBc3NvY2lhdGlvbiBhbmQgdGhlIEhlYXJ0IFJoeXRobSBTb2NpZXR5PC90aXRsZT48c2Vj

b25kYXJ5LXRpdGxlPkNpcmN1bGF0aW9uPC9zZWNvbmRhcnktdGl0bGU+PC90aXRsZXM+PHBlcmlv

ZGljYWw+PGZ1bGwtdGl0bGU+Q2lyY3VsYXRpb248L2Z1bGwtdGl0bGU+PC9wZXJpb2RpY2FsPjxw

YWdlcz5lMzg1LTQ4NDwvcGFnZXM+PHZvbHVtZT4xMTQ8L3ZvbHVtZT48bnVtYmVyPjEwPC9udW1i

ZXI+PGtleXdvcmRzPjxrZXl3b3JkPkFtZXJpY2FuIEhlYXJ0IEFzc29jaWF0aW9uPC9rZXl3b3Jk

PjxrZXl3b3JkPkFycmh5dGhtaWEvKnRoZXJhcHk8L2tleXdvcmQ+PGtleXdvcmQ+RGVhdGgsIFN1

ZGRlbiwgQ2FyZGlhYy8qcHJldmVudGlvbiAmYW1wOyBjb250cm9sPC9rZXl3b3JkPjxrZXl3b3Jk

PkV1cm9wZTwva2V5d29yZD48a2V5d29yZD5IdW1hbnM8L2tleXdvcmQ+PGtleXdvcmQ+UXVhbGl0

eSBBc3N1cmFuY2UsIEhlYWx0aCBDYXJlPC9rZXl3b3JkPjxrZXl3b3JkPlNvY2lldGllcywgTWVk

aWNhbDwva2V5d29yZD48a2V5d29yZD5WZW50cmljdWxhciBEeXNmdW5jdGlvbi8qdGhlcmFweTwv

a2V5d29yZD48L2tleXdvcmRzPjxkYXRlcz48eWVhcj4yMDA2PC95ZWFyPjwvZGF0ZXM+PGFjY2Vz

c2lvbi1udW0+MTY5MzU5OTU8L2FjY2Vzc2lvbi1udW0+PHVybHM+PHJlbGF0ZWQtdXJscz48dXJs

Pmh0dHA6Ly93d3cubmNiaS5ubG0ubmloLmdvdi9lbnRyZXovcXVlcnkuZmNnaT9jbWQ9UmV0cmll

dmUmYW1wO2RiPVB1Yk1lZCZhbXA7ZG9wdD1DaXRhdGlvbiZhbXA7bGlzdF91aWRzPTE2OTM1OTk1

PC91cmw+PC9yZWxhdGVkLXVybHM+PC91cmxzPjwvcmVjb3JkPjwvQ2l0ZT48L0VuZE5vdGU+AAA=

ADDIN EN.CITE.DATA 25. Left cervicothoracic sympathetic ganglionectomy wasintroduced in 1971 for the treatment of adrenergicallytriggered life-threatening ventricular arrhythmias associatedwith the LQTS ADDIN EN.CITE <EndNote><Cite><Author>Moss</Author><Year>1971</Year><RecNum>5161</RecNum><record><rec-number>5161</rec-number><foreign-keys><key app="EN" db-id="fr0tzpp2v9xtpoewa52p0evqsz2dvvst9sd0">5161</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Moss, A. J.</author><author>McDonald, J.</author></authors></contributors><titles><title>Unilateral cervicothoracic sympathetic ganglionectomy for the treatment of long QT interval syndrome</title><secondary-title>N Engl J Med</secondary-title></titles><periodical><full-title>N Engl J Med</full-title></periodical><pages>903-4</pages><volume>285</volume><number>16</number><edition>1971/10/14</edition><keywords><keyword>Adult</keyword><keyword>Arrhythmias, Cardiac/*surgery</keyword><keyword>Cervical Vertebrae</keyword><keyword>*Electrocardiography</keyword><keyword>Female</keyword><keyword>Ganglia, Autonomic</keyword><keyword>Horner Syndrome/etiology</keyword><keyword>Humans</keyword><keyword>Postoperative Complications</keyword><keyword>Stellate Ganglion/surgery</keyword><keyword>*Sympathectomy</keyword><keyword>Syncope/etiology</keyword><keyword>Thoracic Vertebrae</keyword><keyword>Ventricular Fibrillation/complications/prevention &amp; control</keyword></keywords><dates><year>1971</year><pub-dates><date>Oct 14</date></pub-dates></dates><isbn>0028-4793 (Print)</isbn><accession-num>5112730</accession-num><urls><related-urls><url>. This procedure, performed througha limited supraclavicular approach, involves resection of thelower half of the left stellate ganglion and removal of at leastthe second and third thoracic sympathetic ganglia on theleft side ADDIN EN.CITE <EndNote><Cite><Author>Ouriel</Author><Year>1995</Year><RecNum>4372</RecNum><record><rec-number>4372</rec-number><foreign-keys><key app="EN" db-id="fr0tzpp2v9xtpoewa52p0evqsz2dvvst9sd0">4372</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Ouriel, K.</author><author>Moss, A. J.</author></authors></contributors><auth-address>Department of Surgery, University of Rochester School of Medicine and Dentistry, NY 14642, USA.</auth-address><titles><title>Long QT syndrome: an indication for cervicothoracic sympathectomy</title><secondary-title>Cardiovasc Surg</secondary-title></titles><periodical><full-title>Cardiovasc Surg</full-title></periodical><pages>475-8</pages><volume>3</volume><number>5</number><edition>1995/10/01</edition><keywords><keyword>Adolescent</keyword><keyword>Adult</keyword><keyword>Child</keyword><keyword>Child, Preschool</keyword><keyword>Female</keyword><keyword>Ganglia, Sympathetic/surgery</keyword><keyword>*Ganglionectomy/methods</keyword><keyword>Humans</keyword><keyword>Infant</keyword><keyword>Long QT Syndrome/diagnosis/*surgery</keyword><keyword>Male</keyword><keyword>Postoperative Complications</keyword></keywords><dates><year>1995</year><pub-dates><date>Oct</date></pub-dates></dates><isbn>0967-2109 (Print)</isbn><accession-num>8574528</accession-num><urls><related-urls><url> [pii]</electronic-resource-num><language>eng</language></record></Cite></EndNote>40. This surgical therapy is associated withreduction in the frequency of arrhythmogenic syncope inthis syndrome and may be useful as adjunctive therapy inhigh-risk LQTS patients who have recurrent syncopeand/or aborted cardiac arrest despite combined ICD andbeta-blocker therapy or in LQTS patients who cannottolerate beta blockersPEVuZE5vdGU+PENpdGU+PEF1dGhvcj5TY2h3YXJ0ejwvQXV0aG9yPjxZZWFyPjIwMDQ8L1llYXI+

PFJlY051bT4yMzI3PC9SZWNOdW0+PHJlY29yZD48cmVjLW51bWJlcj4yMzI3PC9yZWMtbnVtYmVy

Pjxmb3JlaWduLWtleXM+PGtleSBhcHA9IkVOIiBkYi1pZD0iZnIwdHpwcDJ2OXh0cG9ld2E1MnAw

ZXZxc3oyZHZ2c3Q5c2QwIj4yMzI3PC9rZXk+PC9mb3JlaWduLWtleXM+PHJlZi10eXBlIG5hbWU9

IkpvdXJuYWwgQXJ0aWNsZSI+MTc8L3JlZi10eXBlPjxjb250cmlidXRvcnM+PGF1dGhvcnM+PGF1

dGhvcj5TY2h3YXJ0eiwgUC4gSi48L2F1dGhvcj48YXV0aG9yPlByaW9yaSwgUy4gRy48L2F1dGhv

cj48YXV0aG9yPkNlcnJvbmUsIE0uPC9hdXRob3I+PGF1dGhvcj5TcGF6em9saW5pLCBDLjwvYXV0

aG9yPjxhdXRob3I+T2Rlcm8sIEEuPC9hdXRob3I+PGF1dGhvcj5OYXBvbGl0YW5vLCBDLjwvYXV0

aG9yPjxhdXRob3I+QmxvaXNlLCBSLjwvYXV0aG9yPjxhdXRob3I+RGUgRmVycmFyaSwgRy4gTS48

L2F1dGhvcj48YXV0aG9yPktsZXJzeSwgQy48L2F1dGhvcj48YXV0aG9yPk1vc3MsIEEuIEouPC9h

dXRob3I+PGF1dGhvcj5aYXJlYmEsIFcuPC9hdXRob3I+PGF1dGhvcj5Sb2JpbnNvbiwgSi4gTC48

L2F1dGhvcj48YXV0aG9yPkhhbGwsIFcuIEouPC9hdXRob3I+PGF1dGhvcj5CcmluaywgUC4gQS48

L2F1dGhvcj48YXV0aG9yPlRvaXZvbmVuLCBMLjwvYXV0aG9yPjxhdXRob3I+RXBzdGVpbiwgQS4g

RS48L2F1dGhvcj48YXV0aG9yPkxpLCBDLjwvYXV0aG9yPjxhdXRob3I+SHUsIEQuPC9hdXRob3I+

PC9hdXRob3JzPjwvY29udHJpYnV0b3JzPjxhdXRoLWFkZHJlc3M+RGVwYXJ0bWVudCBvZiBMdW5n

LCBCbG9vZCBhbmQgSGVhcnQsIFVuaXZlcnNpdHkgb2YgUGF2aWEsIFBhdmlhLCBJdGFseS4gUEpR

VEBjb21wdXNlcnZlLmNvbTwvYXV0aC1hZGRyZXNzPjx0aXRsZXM+PHRpdGxlPkxlZnQgY2FyZGlh

YyBzeW1wYXRoZXRpYyBkZW5lcnZhdGlvbiBpbiB0aGUgbWFuYWdlbWVudCBvZiBoaWdoLXJpc2sg

cGF0aWVudHMgYWZmZWN0ZWQgYnkgdGhlIGxvbmctUVQgc3luZHJvbWU8L3RpdGxlPjxzZWNvbmRh

cnktdGl0bGU+Q2lyY3VsYXRpb248L3NlY29uZGFyeS10aXRsZT48L3RpdGxlcz48cGVyaW9kaWNh

bD48ZnVsbC10aXRsZT5DaXJjdWxhdGlvbjwvZnVsbC10aXRsZT48L3BlcmlvZGljYWw+PHBhZ2Vz

PjE4MjYtMzM8L3BhZ2VzPjx2b2x1bWU+MTA5PC92b2x1bWU+PG51bWJlcj4xNTwvbnVtYmVyPjxl

ZGl0aW9uPjIwMDQvMDMvMzE8L2VkaXRpb24+PGtleXdvcmRzPjxrZXl3b3JkPkFkb2xlc2NlbnQ8

L2tleXdvcmQ+PGtleXdvcmQ+QWR1bHQ8L2tleXdvcmQ+PGtleXdvcmQ+Q2hpbGQ8L2tleXdvcmQ+

PGtleXdvcmQ+RWxlY3Ryb2NhcmRpb2dyYXBoeTwva2V5d29yZD48a2V5d29yZD5Gb2xsb3ctVXAg

U3R1ZGllczwva2V5d29yZD48a2V5d29yZD5HYW5nbGlvbmVjdG9teTwva2V5d29yZD48a2V5d29y

ZD5HZW5vdHlwZTwva2V5d29yZD48a2V5d29yZD5IZWFydC9pbm5lcnZhdGlvbjwva2V5d29yZD48

a2V5d29yZD5IdW1hbnM8L2tleXdvcmQ+PGtleXdvcmQ+TG9uZyBRVCBTeW5kcm9tZS9kaWFnbm9z

aXMvbW9ydGFsaXR5LypzdXJnZXJ5PC9rZXl3b3JkPjxrZXl3b3JkPk1hbGU8L2tleXdvcmQ+PGtl

eXdvcmQ+UmlzayBGYWN0b3JzPC9rZXl3b3JkPjxrZXl3b3JkPipTeW1wYXRoZWN0b215PC9rZXl3

b3JkPjwva2V5d29yZHM+PGRhdGVzPjx5ZWFyPjIwMDQ8L3llYXI+PHB1Yi1kYXRlcz48ZGF0ZT5B

cHIgMjA8L2RhdGU+PC9wdWItZGF0ZXM+PC9kYXRlcz48aXNibj4xNTI0LTQ1MzkgKEVsZWN0cm9u

aWMpPC9pc2JuPjxhY2Nlc3Npb24tbnVtPjE1MDUxNjQ0PC9hY2Nlc3Npb24tbnVtPjx1cmxzPjxy

ZWxhdGVkLXVybHM+PHVybD5odHRwOi8vd3d3Lm5jYmkubmxtLm5paC5nb3YvZW50cmV6L3F1ZXJ5

LmZjZ2k/Y21kPVJldHJpZXZlJmFtcDtkYj1QdWJNZWQmYW1wO2RvcHQ9Q2l0YXRpb24mYW1wO2xp

c3RfdWlkcz0xNTA1MTY0NDwvdXJsPjwvcmVsYXRlZC11cmxzPjwvdXJscz48ZWxlY3Ryb25pYy1y

ZXNvdXJjZS1udW0+MTAuMTE2MS8wMS5DSVIuMDAwMDEyNTUyMy4xNDQwMy4xRSYjeEQ7MDEuQ0lS

LjAwMDAxMjU1MjMuMTQ0MDMuMUUgW3BpaV08L2VsZWN0cm9uaWMtcmVzb3VyY2UtbnVtPjxsYW5n

dWFnZT5lbmc8L2xhbmd1YWdlPjwvcmVjb3JkPjwvQ2l0ZT48L0VuZE5vdGU+AAAA

ADDIN EN.CITE PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5TY2h3YXJ0ejwvQXV0aG9yPjxZZWFyPjIwMDQ8L1llYXI+

PFJlY051bT4yMzI3PC9SZWNOdW0+PHJlY29yZD48cmVjLW51bWJlcj4yMzI3PC9yZWMtbnVtYmVy

Pjxmb3JlaWduLWtleXM+PGtleSBhcHA9IkVOIiBkYi1pZD0iZnIwdHpwcDJ2OXh0cG9ld2E1MnAw

ZXZxc3oyZHZ2c3Q5c2QwIj4yMzI3PC9rZXk+PC9mb3JlaWduLWtleXM+PHJlZi10eXBlIG5hbWU9

IkpvdXJuYWwgQXJ0aWNsZSI+MTc8L3JlZi10eXBlPjxjb250cmlidXRvcnM+PGF1dGhvcnM+PGF1

dGhvcj5TY2h3YXJ0eiwgUC4gSi48L2F1dGhvcj48YXV0aG9yPlByaW9yaSwgUy4gRy48L2F1dGhv

cj48YXV0aG9yPkNlcnJvbmUsIE0uPC9hdXRob3I+PGF1dGhvcj5TcGF6em9saW5pLCBDLjwvYXV0

aG9yPjxhdXRob3I+T2Rlcm8sIEEuPC9hdXRob3I+PGF1dGhvcj5OYXBvbGl0YW5vLCBDLjwvYXV0

aG9yPjxhdXRob3I+QmxvaXNlLCBSLjwvYXV0aG9yPjxhdXRob3I+RGUgRmVycmFyaSwgRy4gTS48

L2F1dGhvcj48YXV0aG9yPktsZXJzeSwgQy48L2F1dGhvcj48YXV0aG9yPk1vc3MsIEEuIEouPC9h

dXRob3I+PGF1dGhvcj5aYXJlYmEsIFcuPC9hdXRob3I+PGF1dGhvcj5Sb2JpbnNvbiwgSi4gTC48

L2F1dGhvcj48YXV0aG9yPkhhbGwsIFcuIEouPC9hdXRob3I+PGF1dGhvcj5CcmluaywgUC4gQS48

L2F1dGhvcj48YXV0aG9yPlRvaXZvbmVuLCBMLjwvYXV0aG9yPjxhdXRob3I+RXBzdGVpbiwgQS4g

RS48L2F1dGhvcj48YXV0aG9yPkxpLCBDLjwvYXV0aG9yPjxhdXRob3I+SHUsIEQuPC9hdXRob3I+

PC9hdXRob3JzPjwvY29udHJpYnV0b3JzPjxhdXRoLWFkZHJlc3M+RGVwYXJ0bWVudCBvZiBMdW5n

LCBCbG9vZCBhbmQgSGVhcnQsIFVuaXZlcnNpdHkgb2YgUGF2aWEsIFBhdmlhLCBJdGFseS4gUEpR

VEBjb21wdXNlcnZlLmNvbTwvYXV0aC1hZGRyZXNzPjx0aXRsZXM+PHRpdGxlPkxlZnQgY2FyZGlh

YyBzeW1wYXRoZXRpYyBkZW5lcnZhdGlvbiBpbiB0aGUgbWFuYWdlbWVudCBvZiBoaWdoLXJpc2sg

cGF0aWVudHMgYWZmZWN0ZWQgYnkgdGhlIGxvbmctUVQgc3luZHJvbWU8L3RpdGxlPjxzZWNvbmRh

cnktdGl0bGU+Q2lyY3VsYXRpb248L3NlY29uZGFyeS10aXRsZT48L3RpdGxlcz48cGVyaW9kaWNh

bD48ZnVsbC10aXRsZT5DaXJjdWxhdGlvbjwvZnVsbC10aXRsZT48L3BlcmlvZGljYWw+PHBhZ2Vz

PjE4MjYtMzM8L3BhZ2VzPjx2b2x1bWU+MTA5PC92b2x1bWU+PG51bWJlcj4xNTwvbnVtYmVyPjxl

ZGl0aW9uPjIwMDQvMDMvMzE8L2VkaXRpb24+PGtleXdvcmRzPjxrZXl3b3JkPkFkb2xlc2NlbnQ8

L2tleXdvcmQ+PGtleXdvcmQ+QWR1bHQ8L2tleXdvcmQ+PGtleXdvcmQ+Q2hpbGQ8L2tleXdvcmQ+

PGtleXdvcmQ+RWxlY3Ryb2NhcmRpb2dyYXBoeTwva2V5d29yZD48a2V5d29yZD5Gb2xsb3ctVXAg

U3R1ZGllczwva2V5d29yZD48a2V5d29yZD5HYW5nbGlvbmVjdG9teTwva2V5d29yZD48a2V5d29y

ZD5HZW5vdHlwZTwva2V5d29yZD48a2V5d29yZD5IZWFydC9pbm5lcnZhdGlvbjwva2V5d29yZD48

a2V5d29yZD5IdW1hbnM8L2tleXdvcmQ+PGtleXdvcmQ+TG9uZyBRVCBTeW5kcm9tZS9kaWFnbm9z

aXMvbW9ydGFsaXR5LypzdXJnZXJ5PC9rZXl3b3JkPjxrZXl3b3JkPk1hbGU8L2tleXdvcmQ+PGtl

eXdvcmQ+UmlzayBGYWN0b3JzPC9rZXl3b3JkPjxrZXl3b3JkPipTeW1wYXRoZWN0b215PC9rZXl3

b3JkPjwva2V5d29yZHM+PGRhdGVzPjx5ZWFyPjIwMDQ8L3llYXI+PHB1Yi1kYXRlcz48ZGF0ZT5B

cHIgMjA8L2RhdGU+PC9wdWItZGF0ZXM+PC9kYXRlcz48aXNibj4xNTI0LTQ1MzkgKEVsZWN0cm9u

aWMpPC9pc2JuPjxhY2Nlc3Npb24tbnVtPjE1MDUxNjQ0PC9hY2Nlc3Npb24tbnVtPjx1cmxzPjxy

ZWxhdGVkLXVybHM+PHVybD5odHRwOi8vd3d3Lm5jYmkubmxtLm5paC5nb3YvZW50cmV6L3F1ZXJ5

LmZjZ2k/Y21kPVJldHJpZXZlJmFtcDtkYj1QdWJNZWQmYW1wO2RvcHQ9Q2l0YXRpb24mYW1wO2xp

c3RfdWlkcz0xNTA1MTY0NDwvdXJsPjwvcmVsYXRlZC11cmxzPjwvdXJscz48ZWxlY3Ryb25pYy1y

ZXNvdXJjZS1udW0+MTAuMTE2MS8wMS5DSVIuMDAwMDEyNTUyMy4xNDQwMy4xRSYjeEQ7MDEuQ0lS

LjAwMDAxMjU1MjMuMTQ0MDMuMUUgW3BpaV08L2VsZWN0cm9uaWMtcmVzb3VyY2UtbnVtPjxsYW5n

dWFnZT5lbmc8L2xhbmd1YWdlPjwvcmVjb3JkPjwvQ2l0ZT48L0VuZE5vdGU+AFgA

ADDIN EN.CITE.DATA 41.A summary of ESC/AHA recommendations for Long QT Syndrome Recommendationsis reproduced from the guidelines below: Class ILifestyle modification is recommended for patients with an LQTS diagnosis (clinical and/or molecular). (Level of Evidence: B)Beta blockers are recommended for patients with an LQTS clinical diagnosis (i.e., in the presence of prolonged QT interval). (Level of Evidence: B)Implantation of an ICD along with use of beta blockers is recommended for LQTS patients with previous cardiac arrest and who have reasonable expectation of survival with a good functional status for more than 1 y. (Level of Evidence: A)Class IIaBeta blockers can be effective to reduce SCD in patients with a molecular LQTS analysis and normal QT interval. (Level of Evidence: B)Implantation of an ICD with continued use of beta blockers can be effective to reduce SCD in LQTS patients experiencing syncope and/or VT while receiving beta blockers and who have reasonable expectation of survival with a good functional status for more than 1 y. (Level of Evidence: B)Class IIbLeft cardiac sympathetic neural denervation may be considered for LQTS patients with syncope, torsades de pointes, or cardiac arrest while receiving beta blockers. (Level of Evidence: B)Implantation of an ICD with the use of beta blockers may be considered for prophylaxis of SCD for patients in categories possibly associated with higher risk of cardiac arrest such as LQT2 and LQT3 and who have reasonable expectation of survival with a good functional status for more than 1 y. (Level of Evidence: B)SummaryLQTS is a rare disorder which can be difficult to diagnose, as the QTc can be normal. Furthermore, risk stratification can be challenging. A genetic mutation can be identified in up to ? of patients and assists with the screening of relative and also potentially with risk stratification and is therefore recommended.Also see: 1: QTc interval noted to be prolongedSituation 2: 1st degree relative of patient (alive or dead) is diagnosed with LQTSSample ECGS()LQT1LQT1 is characterised by prolonged QT intervals associated with a broad-based T wave ADDIN EN.CITE <EndNote><Cite><Author>Moss</Author><Year>2003</Year><RecNum>2672</RecNum><record><rec-number>2672</rec-number><foreign-keys><key app="EN" db-id="fr0tzpp2v9xtpoewa52p0evqsz2dvvst9sd0">2672</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Moss, A. J.</author></authors></contributors><auth-address>Cardiology Unit, Department of Medicine, University of Rochester Medical Center, Rochester, NY 14642, USA. heartajm@heart.rochester.edu</auth-address><titles><title>Long QT Syndrome</title><secondary-title>JAMA</secondary-title></titles><periodical><full-title>JAMA</full-title></periodical><pages>2041-4</pages><volume>289</volume><number>16</number><edition>2003/04/24</edition><keywords><keyword>Adrenergic beta-Antagonists/therapeutic use</keyword><keyword>Death, Sudden, Cardiac/etiology</keyword><keyword>Defibrillators, Implantable</keyword><keyword>Electrocardiography</keyword><keyword>Genotype</keyword><keyword>Humans</keyword><keyword>*Long QT Syndrome/diagnosis/genetics/physiopathology/therapy</keyword><keyword>Pacemaker, Artificial</keyword><keyword>Sympathectomy</keyword><keyword>Syncope/etiology</keyword></keywords><dates><year>2003</year><pub-dates><date>Apr 23-30</date></pub-dates></dates><isbn>0098-7484 (Print)</isbn><accession-num>12709446</accession-num><urls><related-urls><url> [pii]</electronic-resource-num><language>eng</language></record></Cite></EndNote>42LQT2LQT2 is characterised by low-amplitude and notched T waves ADDIN EN.CITE <EndNote><Cite><Author>Moss</Author><Year>2003</Year><RecNum>2672</RecNum><record><rec-number>2672</rec-number><foreign-keys><key app="EN" db-id="fr0tzpp2v9xtpoewa52p0evqsz2dvvst9sd0">2672</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Moss, A. J.</author></authors></contributors><auth-address>Cardiology Unit, Department of Medicine, University of Rochester Medical Center, Rochester, NY 14642, USA. heartajm@heart.rochester.edu</auth-address><titles><title>Long QT Syndrome</title><secondary-title>JAMA</secondary-title></titles><periodical><full-title>JAMA</full-title></periodical><pages>2041-4</pages><volume>289</volume><number>16</number><edition>2003/04/24</edition><keywords><keyword>Adrenergic beta-Antagonists/therapeutic use</keyword><keyword>Death, Sudden, Cardiac/etiology</keyword><keyword>Defibrillators, Implantable</keyword><keyword>Electrocardiography</keyword><keyword>Genotype</keyword><keyword>Humans</keyword><keyword>*Long QT Syndrome/diagnosis/genetics/physiopathology/therapy</keyword><keyword>Pacemaker, Artificial</keyword><keyword>Sympathectomy</keyword><keyword>Syncope/etiology</keyword></keywords><dates><year>2003</year><pub-dates><date>Apr 23-30</date></pub-dates></dates><isbn>0098-7484 (Print)</isbn><accession-num>12709446</accession-num><urls><related-urls><url> [pii]</electronic-resource-num><language>eng</language></record></Cite></EndNote>42LQT3LQT3 is characterised by long ST segments with a late-appearing T wave resulting in a long QT interval ADDIN EN.CITE <EndNote><Cite><Author>Moss</Author><Year>2003</Year><RecNum>2672</RecNum><record><rec-number>2672</rec-number><foreign-keys><key app="EN" db-id="fr0tzpp2v9xtpoewa52p0evqsz2dvvst9sd0">2672</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Moss, A. J.</author></authors></contributors><auth-address>Cardiology Unit, Department of Medicine, University of Rochester Medical Center, Rochester, NY 14642, USA. heartajm@heart.rochester.edu</auth-address><titles><title>Long QT Syndrome</title><secondary-title>JAMA</secondary-title></titles><periodical><full-title>JAMA</full-title></periodical><pages>2041-4</pages><volume>289</volume><number>16</number><edition>2003/04/24</edition><keywords><keyword>Adrenergic beta-Antagonists/therapeutic use</keyword><keyword>Death, Sudden, Cardiac/etiology</keyword><keyword>Defibrillators, Implantable</keyword><keyword>Electrocardiography</keyword><keyword>Genotype</keyword><keyword>Humans</keyword><keyword>*Long QT Syndrome/diagnosis/genetics/physiopathology/therapy</keyword><keyword>Pacemaker, Artificial</keyword><keyword>Sympathectomy</keyword><keyword>Syncope/etiology</keyword></keywords><dates><year>2003</year><pub-dates><date>Apr 23-30</date></pub-dates></dates><isbn>0098-7484 (Print)</isbn><accession-num>12709446</accession-num><urls><related-urls><url> [pii]</electronic-resource-num><language>eng</language></record></Cite></EndNote>42References ADDIN EN.REFLIST 1.Schwartz PJ. [From clinical medicine to electrophysiology. The case of the long QT syndrome]. Cardiologia. 1987;32(12):1685-1687.2.Schwartz PJ, Stramba-Badiale M, Crotti L, Pedrazzini M, Besana A, Bosi G, Gabbarini F, Goulene K, Insolia R, Mannarino S, Mosca F, Nespoli L, Rimini A, Rosati E, Salice P, Spazzolini C. Prevalence of the congenital long-QT syndrome. Circulation. 2009;120(18):1761-1767.3.Rautaharju PM, Surawicz B, Gettes LS, Bailey JJ, Childers R, Deal BJ, Gorgels A, Hancock EW, Josephson M, Kligfield P, Kors JA, Macfarlane P, Mason JW, Mirvis DM, Okin P, Pahlm O, van Herpen G, Wagner GS, Wellens H. AHA/ACCF/HRS recommendations for the standardization and interpretation of the electrocardiogram: part IV: the ST segment, T and U waves, and the QT interval: a scientific statement from the American Heart Association Electrocardiography and Arrhythmias Committee, Council on Clinical Cardiology; the American College of Cardiology Foundation; and the Heart Rhythm Society: endorsed by the International Society for Computerized Electrocardiology. Circulation. 2009;119(10):e241-250.4.Taggart NW, Haglund CM, Tester DJ, Ackerman MJ. Diagnostic miscues in congenital long-QT syndrome. Circulation. 2007;115(20):2613-2620.5.Goldenberg I, Mathew J, Moss AJ, McNitt S, Peterson DR, Zareba W, Benhorin J, Zhang L, Vincent GM, Andrews ML, Robinson JL, Morray B. Corrected QT variability in serial electrocardiograms in long QT syndrome: the importance of the maximum corrected QT for risk stratification. J Am Coll Cardiol. 2006;48(5):1047-1052.6.Vincent GM, Timothy KW, Leppert M, Keating M. The spectrum of symptoms and QT intervals in carriers of the gene for the long-QT syndrome. N Engl J Med. 1992;327(12):846-852.7.Priori SG, Napolitano C, Schwartz PJ. Low penetrance in the long-QT syndrome: clinical impact. Circulation. 1999;99(4):529-533.8.Vetter VL. Clues or miscues? How to make the right interpretation and correctly diagnose long-QT syndrome. Circulation. 2007;115(20):2595-2598.9.Goldenberg I, Moss AJ, Zareba W. QT interval: how to measure it and what is "normal". J Cardiovasc Electrophysiol. 2006;17(3):333-336.10.Basavarajaiah S, Wilson M, Whyte G, Shah A, Behr E, Sharma S. Prevalence and significance of an isolated long QT interval in elite athletes. Eur Heart J. 2007;28(23):2944-2949.11.Martin AB, Garson A, Jr., Perry JC. Prolonged QT interval in hypertrophic and dilated cardiomyopathy in children. Am Heart J. 1994;127(1):64-70.12.Jouven X, Hagege A, Charron P, Carrier L, Dubourg O, Langlard JM, Aliaga S, Bouhour JB, Schwartz K, Desnos M, Komajda M. Relation between QT duration and maximal wall thickness in familial hypertrophic cardiomyopathy. Heart. 2002;88(2):153-157.13.Viitasalo M, Oikarinen L, Vaananen H, Kontula K, Toivonen L, Swan H. U-waves and T-wave peak to T-wave end intervals in patients with catecholaminergic polymorphic ventricular tachycardia, effects of beta-blockers. Heart Rhythm. 2008;5(10):1382-1388.14.Peters S, Schulze-Bahr E, Etheridge SP, Tristani-Firouzi M. Sudden cardiac death in Andersen-Tawil syndrome. Europace. 2007;9(3):162-166.15.Acquired Long QT Syndrome Secondary to Noncardiac Conditions. In: A. John Camm YGYMM, ed. Acquired Long QT Syndrome (First Edition); 2007:171-181.16.Genovesi S, Prata Pizzala DM, Pozzi M, Ratti L, Milanese M, Pieruzzi F, Vincenti A, Stella A, Mancia G, Stramba-Badiale M. QT interval prolongation and decreased heart rate variability in cirrhotic patients: relevance of hepatic venous pressure gradient and serum calcium. Clin Sci (Lond). 2009;116(12):851-859.17.Parthenakis FI, Vardas PE, Ralidis L, Dritsas A, Nihoyannopoulos P. QT Interval in Cardiac Amyloidosis. Clin Cardiol. 1996;19(1):A 22, 442.18.Schwartz PJ, Moss AJ, Vincent GM, Crampton RS. Diagnostic criteria for the long QT syndrome. An update. Circulation. 1993;88(2):782-784.19.Davignon A, Rautaharju B, Boisselle E, Soumis F, Megelas M, Choquette A. Normal ECG standards for infants and children. Paediatric Cardiology. 1980;1:123-130.20.Agarwal SC, Crook JR, Pepper CB. Herbal remedies - how safe are they? A case report of polymorphic ventricular tachycardia/ventricular fibrillation induced by herbal medication used for obesity. Int J Cardiol. 2005;106(2):260-261.21.Jervell A, Lange-Nielsen F. Congenital deaf-mutism, functional heart disease with prolongation of the Q-T interval and sudden death. Am Heart J. 1957;54(1):59-68.22.Yoon G, Oberoi S, Tristani-Firouzi M, Etheridge SP, Quitania L, Kramer JH, Miller BL, Fu YH, Ptacek LJ. Andersen-Tawil syndrome: prospective cohort analysis and expansion of the phenotype. Am J Med Genet A. 2006;140(4):312-321.23.Sicouri S, Timothy KW, Zygmunt AC, Glass A, Goodrow RJ, Belardinelli L, Antzelevitch C. Cellular basis for the electrocardiographic and arrhythmic manifestations of Timothy syndrome: effects of ranolazine. Heart Rhythm. 2007;4(5):638-647.24.Horner JM, Ackerman MJ. Ventricular ectopy during treadmill exercise stress testing in the evaluation of long QT syndrome. Heart Rhythm. 2008;5(12):1690-1694.25.Zipes DP, Camm AJ, Borggrefe M, Buxton AE, Chaitman B, Fromer M, Gregoratos G, Klein G, Moss AJ, Myerburg RJ, Priori SG, Quinones MA, Roden DM, Silka MJ, Tracy C, Smith SC, Jr., Jacobs AK, Adams CD, Antman EM, Anderson JL, Hunt SA, Halperin JL, Nishimura R, Ornato JP, Page RL, Riegel B, Blanc JJ, Budaj A, Dean V, Deckers JW, Despres C, Dickstein K, Lekakis J, McGregor K, Metra M, Morais J, Osterspey A, Tamargo JL, Zamorano JL. ACC/AHA/ESC 2006 Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death: a report of the American College of Cardiology/American Heart Association Task Force and the European Society of Cardiology Committee for Practice Guidelines (writing committee to develop Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death): developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society. Circulation. 2006;114(10):e385-484.26.Priori SG, Schwartz PJ, Napolitano C, Bloise R, Ronchetti E, Grillo M, Vicentini A, Spazzolini C, Nastoli J, Bottelli G, Folli R, Cappelletti D. Risk stratification in the long-QT syndrome. N Engl J Med. 2003;348(19):1866-1874.27.Clinical indications for genetic testing in familial sudden cardiac death syndromes: an HRUK position statement. Heart. 2008;94(4):502-507.28.Schwartz PJ, Periti M, Malliani A. The long Q-T syndrome. Am Heart J. 1975;89:378-390.29.Moss AJ, Zareba W, Hall WJ, Schwartz PJ, Crampton RS, Benhorin J, Vincent GM, Locati EH, Priori SG, Napolitano C, Medina A, Zhang L, Robinson JL, Timothy K, Towbin JA, Andrews ML. Effectiveness and limitations of beta-blocker therapy in congenital long-QT syndrome. Circulation. 2000;101(6):616-623.30.Priori SG, Napolitano C, Schwartz PJ, Grillo M, Bloise R, Ronchetti E, Moncalvo C, Tulipani C, Veia A, Bottelli G, Nastoli J. Association of long QT syndrome loci and cardiac events among patients treated with beta-blockers. JAMA. 2004;292(11):1341-1344.31.Schwartz PJ, Priori SG, Spazzolini C, Moss AJ, Vincent GM, Napolitano C, Denjoy I, Guicheney P, Breithardt G, Keating MT, Towbin JA, Beggs AH, Brink P, Wilde AA, Toivonen L, Zareba W, Robinson JL, Timothy KW, Corfield V, Wattanasirichaigoon D, Corbett C, Haverkamp W, Schulze-Bahr E, Lehmann MH, Schwartz K, Coumel P, Bloise R. Genotype-phenotype correlation in the long-QT syndrome: gene-specific triggers for life-threatening arrhythmias. Circulation. 2001;103(1):89-95.32.Vincent GM, Schwartz PJ, Denjoy I, Swan H, Bithell C, Spazzolini C, Crotti L, Piippo K, Lupoglazoff JM, Villain E, Priori SG, Napolitano C, Zhang L. High efficacy of beta-blockers in long-QT syndrome type 1: contribution of noncompliance and QT-prolonging drugs to the occurrence of beta-blocker treatment "failures". Circulation. 2009;119(2):215-221.33.Nademanee K. Genotype-Phenotype Relationship in the Long QT Syndrome: Brimming with Knowledge but Thirsting for a Therapeutic Solution. J Am Coll Cardiol. 2009;54:2063-2064.34.Implantable Cardioverter Defibrillators for Arrhythmias. The National Institute for Health and Clinical Excellence. Technology Appraisal 95. 2006.35.Crotti L, Lundquist AL, Insolia R, Pedrazzini M, Ferrandi C, De Ferrari GM, Vicentini A, Yang P, Roden DM, George AL, Jr., Schwartz PJ. KCNH2-K897T is a genetic modifier of latent congenital long-QT syndrome. Circulation. 2005;112(9):1251-1258.36.Moss AJ, Shimizu W, Wilde AA, Towbin JA, Zareba W, Robinson JL, Qi M, Vincent GM, Ackerman MJ, Kaufman ES, Hofman N, Seth R, Kamakura S, Miyamoto Y, Goldenberg I, Andrews ML, McNitt S. Clinical aspects of type-1 long-QT syndrome by location, coding type, and biophysical function of mutations involving the KCNQ1 gene. Circulation. 2007;115(19):2481-2489.37.Moss AJ, Zareba W, Kaufman ES, Gartman E, Peterson DR, Benhorin J, Towbin JA, Keating MT, Priori SG, Schwartz PJ, Vincent GM, Robinson JL, Andrews ML, Feng C, Hall WJ, Medina A, Zhang L, Wang Z. Increased risk of arrhythmic events in long-QT syndrome with mutations in the pore region of the human ether-a-go-go-related gene potassium channel. Circulation. 2002;105(7):794-799.38.Shimizu W, Moss AJ, Wilde AAM, Towbin JA, Ackerman MJ, January CT, Tester DJ, Zareba W, Robinson JL, Qi M, Vincent GM, Kaufman ES, Hofman N, Noda T, Kamakura S, Miyamoto Y, Shah S, Amin V, Goldenberg I, Andrews ML, McNitt S. Genotype-Phenotype Aspects of Type 2 Long QT Syndrome. J Am Coll Cardiol. 2009;54:2052-2062.39.Moss AJ, McDonald J. Unilateral cervicothoracic sympathetic ganglionectomy for the treatment of long QT interval syndrome. N Engl J Med. 1971;285(16):903-904.40.Ouriel K, Moss AJ. Long QT syndrome: an indication for cervicothoracic sympathectomy. Cardiovasc Surg. 1995;3(5):475-478.41.Schwartz PJ, Priori SG, Cerrone M, Spazzolini C, Odero A, Napolitano C, Bloise R, De Ferrari GM, Klersy C, Moss AJ, Zareba W, Robinson JL, Hall WJ, Brink PA, Toivonen L, Epstein AE, Li C, Hu D. Left cardiac sympathetic denervation in the management of high-risk patients affected by the long-QT syndrome. Circulation. 2004;109(15):1826-1833.42.Moss AJ. Long QT Syndrome. JAMA. 2003;289(16):2041-2044. ................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download