• Cardiovascular
• Elite performance

We saw with great interest the article “Return to play? Athletes with congenital long QT syndrome” recently published in this journal,1 describing the outcome of adolescents with long QT syndrome (LQTS) exposed to regular exercise training and sport participation for a 5-year period.

The authors claim that this experience represents ground for the revision of existing criteria of the Bethesda Conference (BC) #36 and European Society of Cardiology (ESC) recommendations regarding sport participation of young patients with LQTS.2 ,3 For this reason, we believed it appropriate to articulate pertinent considerations relative to their unique experience.

The novel observation refers to LQTS genotype-positive–phenotype-negative asymptomatic children actively involved in varied sport programmes. None incurred adverse events or developed cardiac symptoms in the 5-year period, supporting the substantial benign nature of this condition. This observation substantiates the clinical perception that gene abnormality, per se, should not be viewed as disease and, by showing the absence of significant risk for individuals with no symptoms and normal QTc interval (mean, 0.44 s in this subset), reassures clinicians of the favourable outcome of these young ‘patients’.

The present experience supports the concept that participation in sport activities (at youth league and high-school) does not convey increased risk and is not associated with the occurrence of adverse events in …