Inherited arrhythmias

LQTS Schwartz Score

Assesses the diagnostic probability of congenital long QT syndrome using ECG, clinical, family-history and genetic findings.

Before scoring

ECG findings should be assessed in the absence of drugs, electrolyte abnormalities or other disorders known to prolong the QT interval. Resting QTc should be calculated with the Bazett formula.

Diagnostic variables

Select applicable findings

01

Resting QTc

Select only one resting QTc category.

02

Additional ECG findings

Select each independent finding that applies.

03

Syncope

Select only the highest applicable syncope category.

04

Clinical history

Select the finding if present.

05

Family history

The same family member should not be used for both family-history criteria.

06

Genetic finding

Use only a clinically classified pathogenic or likely pathogenic variant.

Interpretation

Low probability

≤1 point

Low clinical probability of LQTS.

Intermediate probability

1.5–3 points

Further clinical assessment may be required.

Clinical diagnosis supported

>3 points

Supports LQTS diagnosis when secondary causes are absent.

Clinical limitations

This is a diagnostic support score and does not predict an individual patient's future arrhythmic-event risk.

Acquired QT prolongation from medication, electrolyte disturbance, bradyarrhythmia or systemic disease should be excluded before interpreting the score.

A pathogenic LQTS-associated genetic variant can establish the diagnosis even when the resting QTc is normal.

Management decisions require specialist assessment, genotype interpretation and individualized risk evaluation.

References

Schwartz PJ, Crotti L, Insolia R. Long-QT syndrome: from genetics to management. Circ Arrhythm Electrophysiol. 2012 Aug 1;5(4):868-77. doi: 10.1161/CIRCEP.111.962019. Erratum in: Circ Arrhythm Electrophysiol. 2012 Dec;5(6):e119-20. PMID: 22895603; PMCID: PMC3461497.

Zeppenfeld K, Tfelt-Hansen J, de Riva M, Winkel BG, Behr ER, Blom NA, Charron P, Corrado D, Dagres N, de Chillou C, Eckardt L, Friede T, Haugaa KH, Hocini M, Lambiase PD, Marijon E, Merino JL, Peichl P, Priori SG, Reichlin T, Schulz-Menger J, Sticherling C, Tzeis S, Verstrael A, Volterrani M; ESC Scientific Document Group. 2022 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death. Eur Heart J. 2022 Oct 21;43(40):3997-4126. doi: 10.1093/eurheartj/ehac262. PMID: 36017572.

This calculator provides clinical decision support and does not replace expert ECG review or inherited-arrhythmia consultation.