Genotype-phenotype-guided medical and surgical intervention in long QT syndrome Robyn J. Hylind, MS, CGC, Virginie Beausejour Ladouceur, MD, Francis Fynn-Thompson,

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Genotype-phenotype-guided medical and surgical intervention in long QT syndrome Robyn J. Hylind, MS, CGC, Virginie Beausejour Ladouceur, MD, Francis Fynn-Thompson, MD, Shannon E. Hourigan, PhD, Vassilios J. Bezzerides, PhD, MD, Dominic J. Abrams, MD, MRCP HeartRhythm Case Reports Volume 4, Issue 1, Pages 14-17 (January 2018) DOI: 10.1016/j.hrcr.2017.09.001 Copyright © 2017 Heart Rhythm Society Terms and Conditions

Figure 1 A depiction of the potassium channel, KvLQT1, encoded by the gene KCNQ1, is shown with 6 transmembrane domains (S1–S6) seen spanning the cardiomyocyte membrane. The site of the pathogenic variant identified in the proband—KCNQ1 c.1552C>T; p.R518X—is depicted by the blue circle in the C-terminus. HeartRhythm Case Reports 2018 4, 14-17DOI: (10.1016/j.hrcr.2017.09.001) Copyright © 2017 Heart Rhythm Society Terms and Conditions

Figure 2 A multigenerational family pedigree with the proband denoted by an arrow. Males are represented by squares and females by circles. Blue quadrants represent the KCNQ1 R518X genotype, and red quadrants represent long QT syndrome. A&W= alive and well; d. = died; MI = myocardial infarct; yo = years old. HeartRhythm Case Reports 2018 4, 14-17DOI: (10.1016/j.hrcr.2017.09.001) Copyright © 2017 Heart Rhythm Society Terms and Conditions

Figure 3 Corrected QT intervals measured in the patient during the recovery period from exercise under the following conditions: A: on 20 mg nadolol therapy, B: on no therapy, C: post left cardiac sympathectomy denervation. The normal range (2nd to 98th percentiles) derived from control subjects is shown in gray.15 HeartRhythm Case Reports 2018 4, 14-17DOI: (10.1016/j.hrcr.2017.09.001) Copyright © 2017 Heart Rhythm Society Terms and Conditions