Revised D&T Statement on GnRHa and Prolonged QT 2017

In discussion with our cardiology and pharmacy colleagues, the PES Drug & Therapeutics Committee has generated the following recommendation for individuals receiving GnRHa therapy.

1. Before starting GnRHa therapy, providers should inquire about other medications the individual is taking and any symptoms concerning for an arrhythmia.
2. A screening ECG is recommended if the individual:
   a. Is receiving other medications known to cause prolonged QT interval,
   OR b. Has a history of congenital heart disease, arrhythmia or Long QT Syndrome,
   OR c. Has a family history of Long QT Syndrome or sudden cardiac death,
   OR d. Has symptoms concerning for Long QT Syndrome including syncope.
3. If a screening ECG is performed, repeat ECG should be performed when the GnRHa dose has reached steady state.
4. Referral to cardiology should be made if the individual has Long QT Syndrome, which includes a prolonged QTc, or other ECG abnormalities, symptoms or family history of Long QT Syndrome or sudden death.
5. Providers should counsel their patients about symptoms of arrhythmia, including palpitations and syncope.
6. Providers should continue to inquire about new medications during ongoing GnRHa therapy.