{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T19:21:37Z","timestamp":1792524097958,"version":"4.5.0"},"reference-count":18,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2025,10,18]],"date-time":"2025-10-18T00:00:00Z","timestamp":1760745600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,10,31]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Few medical decisions have a greater impact on the life of patients affected by either long QT syndrome (LQTS) or catecholaminergic polymorphic ventricular tachycardia (CPVT) as the one to recommend an implantable cardioverter defibrillator (ICD) or not. If the decision is correct, a life might be saved or a litany of ICD-related complications might be avoided. If it is wrong, well you can fill in the blanks. Many physicians take the fastest and simplest road by recommending an ICD which represents \u2018double protection\u2019: for the patients and for themselves. Our opinion is that this requires a very careful consideration about the pros and cons and should be taken neither lightly nor quickly. Moreover, there is another side to this moon, which also requires more thought than usually assumed. As to LQTS and CPVT, the current data strongly indicate that when high risk patients are treated with either combination drug therapy comprising beta blockers and mexiletine (LQTS) or beta blockers and flecainide (CPVT) or triple therapy with left cardiac sympathetic denervation as the treatment intensifier, mortality is close to zero and most patients have no life-threatening events. Thus, we stand by our view that most patients still do not need and should not receive an ICD. However, sometimes patients are desperately worried for the fear of dying suddenly and ask for an ICD despite being at low risk. Their request should be listened to, respected, and considered with empathy because immortality cannot be guaranteed. We believe that both expertise and compassion are quintessential to practicing the science and art of medicine.<\/jats:p>","DOI":"10.1093\/europace\/euaf266","type":"journal-article","created":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T12:25:09Z","timestamp":1760617509000},"source":"Crossref","is-referenced-by-count":4,"title":["Implantable cardioverter defibrillators for long QT syndrome and catecholaminergic polymorphic ventricular tachycardia? (Not so fast, Louis)"],"prefix":"10.1093","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0367-1048","authenticated-orcid":false,"given":"Peter J","family":"Schwartz","sequence":"first","affiliation":[{"name":"Istituto Auxologico Italiano IRCCS, Center for Cardiac Arrhythmias of Genetic Origin and Laboratory of Cardiovascular Genetics , Via Pier Lombardo, 22, Milano 20135 ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8011-3333","authenticated-orcid":false,"given":"Michael J","family":"Ackerman","sequence":"additional","affiliation":[{"name":"Departments of Cardiovascular Medicine, Pediatric and Adolescent Medicine, and Molecular Pharmacology & Experimental Therapeutics; Divisions of Heart Rhythm Services and Pediatric Cardiology; Windland Smith Rice Genetic Heart Rhythm Clinic and Windland Smith Rice Sudden Death Genomics Laboratory, Mayo Clinic , Rochester, MN ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,10,18]]},"reference":[{"key":"2025111206321151200_euaf266-B1","doi-asserted-by":"crossref","first-page":"1152","DOI":"10.1053\/euhj.1999.1677","article-title":"The legal implications of medical guidelines. A task force of the European Society of Cardiology","volume":"20","author":"Schwartz","year":"1999","journal-title":"Eur Heart J"},{"key":"2025111206321151200_euaf266-B2","first-page":"e272","article-title":"2017 AHA\/ACC\/HRS guideline 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 on Clinical Practice Guidelines and the Heart Rhythm Society","volume":"138","author":"Al-Khatib","year":"2018","journal-title":"Circulation"},{"key":"2025111206321151200_euaf266-B3","doi-asserted-by":"crossref","first-page":"3467","DOI":"10.1093\/eurheartj\/ehaf394","article-title":"Are long QT syndrome patients managed differently in different countries?","volume":"46","author":"Schwartz","year":"2025","journal-title":"Eur Heart J"},{"key":"2025111206321151200_euaf266-B4","doi-asserted-by":"crossref","first-page":"3453","DOI":"10.1093\/eurheartj\/ehaf365","article-title":"Long QT syndrome in children and adolescents: risk factors and outcomes in a large German cohort","volume":"46","author":"Lippert","year":"2025","journal-title":"Eur Heart J"},{"key":"2025111206321151200_euaf266-B5","doi-asserted-by":"crossref","first-page":"2076","DOI":"10.1016\/j.jacc.2021.09.017","article-title":"Effectiveness of implantable cardioverter-defibrillators to reduce mortality in patients with long QT syndrome","volume":"78","author":"Wang","year":"2021","journal-title":"J Am Coll Cardiol"},{"key":"2025111206321151200_euaf266-B6","doi-asserted-by":"crossref","first-page":"2073","DOI":"10.1016\/j.hrthm.2024.09.063","article-title":"Frequency of and outcomes associated with nonadherence to guideline-based recommendations for an implantable cardioverter-defibrillator in patients with congenital long QT syndrome","volume":"22","author":"Neves","year":"2025","journal-title":"Heart Rhythm"},{"key":"2025111206321151200_euaf266-B7","doi-asserted-by":"crossref","first-page":"2096","DOI":"10.1093\/eurheartj\/ehac134","article-title":"Cardiac sympathetic denervation in the prevention of genetically mediated life-threatening ventricular arrhythmias","volume":"43","author":"Schwartz","year":"2022","journal-title":"Eur Heart J"},{"key":"2025111206321151200_euaf266-B8","doi-asserted-by":"crossref","first-page":"2647","DOI":"10.1093\/eurheartj\/ehae289","article-title":"Long QT syndrome: importance of reassessing arrhythmic risk after treatment initiation","volume":"45","author":"Dusi","year":"2024","journal-title":"Eur Heart J"},{"key":"2025111206321151200_euaf266-B9","doi-asserted-by":"crossref","first-page":"1661","DOI":"10.1093\/eurheartj\/ehab007","article-title":"Precision medicine and cardiac channelopathies: when dreams meet reality","volume":"42","author":"Gnecchi","year":"2021","journal-title":"Eur Heart J"},{"key":"2025111206321151200_euaf266-B10","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1016\/j.tcm.2022.06.006","article-title":"Precision therapy in congenital long QT syndrome","volume":"34","author":"Neves","year":"2024","journal-title":"Trends Cardiovasc Med"},{"key":"2025111206321151200_euaf266-B11","doi-asserted-by":"crossref","first-page":"euad180","DOI":"10.1093\/europace\/euad180","article-title":"From gene-discovery to gene-tailored clinical management: 25 years of research in channelopathies and cardiomyopathies","volume":"25","author":"Crotti","year":"2023","journal-title":"Europace"},{"key":"2025111206321151200_euaf266-B12","doi-asserted-by":"crossref","first-page":"3997","DOI":"10.1093\/eurheartj\/ehac262","article-title":"2022 ESC guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death","volume":"43","author":"Zeppenfeld","year":"2022","journal-title":"Eur Heart J"},{"key":"2025111206321151200_euaf266-B13","doi-asserted-by":"crossref","first-page":"euad091","DOI":"10.1093\/europace\/euad091","article-title":"Spotlight on the 2022 ESC guideline management of ventricular arrhythmias and prevention of sudden cardiac death: 10 novel key aspects","volume":"25","author":"K\u00f6nemann","year":"2023","journal-title":"Europace"},{"key":"2025111206321151200_euaf266-B14","doi-asserted-by":"crossref","first-page":"1272","DOI":"10.1161\/CIRCULATIONAHA.110.950147","article-title":"Who are the long-QT syndrome patients who receive an implantable cardioverter defibrillator and what happens to them? 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